EVERGREEN HEALTH complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.

EVERGREEN HEALTH does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

EVERGREEN HEALTH provides to people with disabilities free aids and services to communicate effectively with us, such as:

·      Qualified sign language interpreters

·      Written information in other formats (large print, audio, accessible electronic formats, other formats)

EVERGREEN HEALTH provides to people whose primary language is not English free language services, such as:

·      Qualified Interpreters

·      Information written in other languages

IF YOU NEED THESES SERVICES, please ask a member of your care team who will assist you in facilitating a communication service.

If you believe that Evergreen Health 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 by mail, fax, email or in person by addressing the grievance to:

Matthew John Pasquarella
Corporate Compliance Officer
Evergreen Association of WNY
206 South Elmwood Ave.
Buffalo, NY14201

Office: 716-847-2441
Fax: 716-332-1157

Email: mjpasquarella@evergreenhs.org

If you need help to file a grievance, Matthew John Pasquarella 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 though the Office of 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. 2021

1-800-386-1019, 800 537-7697 (TDD)

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html