Discrimination is Against the LawTraverse Bay Internal Medicine complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Traverse Bay Internal Medicine does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Traverse Bay Internal Medicine:
• 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 need these services, contact Tara Worm, Medical Practice Manager.
If you believe that Traverse Bay Internal Medicine has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Tara Worm, Medical Practice Manager. Address: 4977 Skyview Court, Traverse City, MI 49684.
Phone number: 231-486-5516, Fax: 231-421-1439, Email: manager@traversebayim.com.

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Tara Worm, Medical Practice Manager is available to help 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
1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

Taglines below to inform individuals with Limited English Proficiency (LEP) of Language Assistance Services.ENGLISH:
ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call (231) 486-5516.
SPANISH:
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (231) 486-5516.
ARABIC:
)ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم 231)486-5516 (رقم
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 (231) 486-5516
ASSYRIAN:
ܙܘܼܗܵܪܵܐ: ܐܸܢ ܐܲܚܬܘܿܢ ܟܹܐ ܗܲܡܙܸܡܝܼܬܘܿܢ ܠܸܫܵܢܵܐ ܐܵܬܘܿܪܵܝܵܐ، ܡܵܨܝܼܬܘܿܢ ܕܩܲܒܠܝܼܬܘܿܢ
(231-486-5516)
VIETNAMESE:
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số
(231) 486-5516
ALBANIAN:
KUJDES: Nëse flitni shqip, për ju ka në dispozicion shërbime të asistencës gjuhësore, pa pagesë. Telefononi në (231) 486-5516
KOREAN:
주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. (231-486-5516
BENGALI:
লক্ষ্য করুনঃ যদি আপনি বাংলা, কথা বলতে পারেন, তাহলে নিঃখরচায় ভাষা সহায়তা পরিষেবা উপলব্ধ আছে। ফোন করুন ১(231)486-5516
POLISH:
UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer (231) 486-5516
GERMAN:
ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: (231) 486-5516
ITALIAN:
ATTENZIONE: In caso la lingua parlata sia l’italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero (231) 486-5516
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。 (231) 486-5516
RUSSIAN:
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните (231) 486-5516
SERBO-CROATIAN:
OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su vam besplatno. Nazovite (231) 486-5516
TAGALONG:
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa (231) 486-5516