NOTICE OF NON-DISCRIMINATION PURSUANT TO ACA SECTION 1557
Titusville Area Hospital:
Provides free aids and services to people with disabilities to communicate effectively with us, such as:
- Qualified sign language interpreters
- Written information in other formats (large print, audio, accessible electronic formats, other formats)
- Provides free language services to people whose primary language is not English, such as:
qualified interpreters - Information written in other languages
If you believe that Titusville Area Hospital has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex (including pregnancy, sexual orientation, and gender identity) you can file a grievance with: TAH Patient Representative, by mail at 406 West Oak St., Titusville, PA 16354, by telephone at 814-827-1851, or toll-free at 1-800-950-1851, facsimile (814) 827-6345. If you need help filing a grievance, the Patient Representative is available to you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
Phone:1-800-368-1019
TDD: 800-537-7697
Complaint forms are available at: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf