611 Sherman Avenue East
Fort Atkinson, WI 53538
(920) 568-5000
La linea de mensajes: (920) 568-5001

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Nondiscrimination and Accessibility Requirements and Nondiscrimination Statement:
Discrimination is Against the Law

Fort HealthCare, Inc. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Fort HealthCare does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Fort HealthCare provides:

  • Free aids and services to people with disabilities to communicate effectively with us.
  • Free language services to people whose primary language is not English.

If you believe that Fort HealthCare 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 our Director of Quality and Risk Management at 611 Sherman Avenue East, Fort Atkinson, WI 53538, by calling 920-568-5278 during the hours of 8:00 a.m. to 4:00 p.m. Monday through Friday, or by fax at 920-568-6051. If you need help filing a grievance, our Director of Quality and Risk Management 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 also available at http://www.hhs.gov/ocr/office/file/index.html.

♦The following information is required by law to be posted for assistance in filing nondiscriminatory grievances.♦

ATTENTION: If you need language assistance services call 1-920-568-5278.

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-920-568-5278 (SPANISH)

LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj.   Hu rau 1-920-568-5278. (HMONG)

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 1-920-568-5278。(CHINESE)

ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-920-568-5278. (GERMAN)

ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم 1-8725-865-029 (ARABIC)

ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-920-568-5278. (RUSSIAN)

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-920-568-5278 (KOREAN)

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-920-568-5278. (VIETNAMESE)

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 1-920-568-5278. (PENNSYLVANIA DUTCH)

ໂປດ​ຊາບ: ຖ້າ​ວ່າ ທ່ານ​ເວົ້າ​ພາ​ສາ ລາວ, ການ​ບໍ​ລິ​ການ​ຊ່ວຍ​ເຫຼືອ​ດ້ານ​ພາ​ສາ, ໂດຍບໍ່​ເສັຽ​ຄ່າ, ແມ່ນມີ​ພ້ອມໃຫ້​ທ່ານ. ໂທ​ຣ 1-920-568-5278. (LOATIAN)

ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 1920-568-5278. (FRENCH)

UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 1-920-568-5278. (POLISH)

ध्यान दें: यदि आप हिंदी बोलते हैं तो आपके लिए मुफ्त में भाषा सहायता सेवाएं उपलब्ध हैं। 1-920-568-5278 (HINDI)

KUJDES: Nëse flitni shqip, për ju ka në dispozicion shërbime të asistencës gjuhësore, pa pagesë. Telefononi në 1-920-568-5278. (ALBANIAN)

PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-920-568-5278 (TAGALOG)