765.474.7838 (p)
765.474.7853 (f)

Notice of Nondiscrimination

It is against the law to Discriminate against any individual.

Sagamore Surgical Services follows the Affordable Care Act and Office of Civil Rights law (Section 1557) not to discriminate against anyone due to:  race, color, national origin, sex, age, or disability.

Sagamore Surgical Services will take steps to offer a qualified interpreter free of charge to the patient with the inability to communicate with physicians and staff.

Auxiliary aids and services include, but are not limited to:

*Qualified sign language interpreters

*Large print materials

*Qualified interpreter by phone to individuals that English is not the primary language.

*Information written in other languages

If you are in need of these services contact:  Marla Kantz, R.N., Director of Nursing.  765-474-7838 extension 222.

If you speak English, language assistance services, free of charge, are available to you. Call 1-800-225-5254.

Arabic:  ) -1 .800-225-5254  ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم 1 .800-225-5254

Chinese:  注意:如果您使用繁體中文,您可以免費獲得語言援助服務。請致電 1-800-225-5254

Dutch:  AANDACHT:  Als u nederlands spreekt, kunt u gratis gebruikmaken van de taalkundige diensten. Bel 1-800-225-5254

French: Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 1-800-225-5254.

German: ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-800-225-5254.

Hindi:   ध्यान द􁱶: य􁳰द आप 􁳲हदी बोलते ह 􁱹तो आपके िलए मुफ्त म􁱶 भाषा सहायता सेवाएं उपलब्ध ह।􁱹 1-800-225-5254.

Japanese:  注意事項:日本語を話される場合、無料の言語支援をご利用いただけます。1-800-225-5254  まで、お電話にてご連絡ください。

Korean:  주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-800-225-5254 번으로 전화해 주십시오.

Pennsylvania Dutch: Wann du [Deitsch (Pennsylvania German / Dutch)] schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff: Call 1-800-225-5254.

Punjabi: ਲਾਗੂ ਸੰਘੀ ਨਾਗਿਰਕ ਹੱਕ􀁿 ਦੇ ਕਾਨੂੰਨ􀁿 ਦੀ ਪਾਲਣਾ ਕਰਦੀ ਹੈ ਅਤੇ ਨਸਲ, ਰੰਗ, ਰਾਸ਼ਟਰੀ ਮੂਲ, ਉਮਰ, ਅਸਮਰਥਤਾ, ਜ􀁿 ਿਲੰਗ ‘ਤੇ ਅਧਾਰ ‘ਤੇ ਿਵਤਕਰਾ ਨਹ􀂀 ਕਰਦੀ ਹੈ।. 1-800-225-5254.

Russian: ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-800-225-5254.

Spanish: ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-225-5254.

Tagalog: PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-800-225-5254.

Vietnamese: tuân thủ luật dân quyền hiện hành của Liên bang và không phân biệt đối xử dựa trên chủng tộc, màu da, nguồn gốc quốc gia, độ tuổi, khuyết tật, hoặc giới tính.  1-800-225-5254.

If you feel you have been discriminated in any way, or services you should have received please contact Marla Kantz, R.N., Director of Nursing

Or by mail:  2320 Concord Road, Suite B
Lafayette, IN.  47909


To express a complaint or grievance you may contact:

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, DC 20201
Website: www.hhs.gov/ocr
Email: 1557@hhs.gov
Toll Free: (800) 368-1019
TDD Toll-Free: (800) 537-7697