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Fountain Point Surgery Center Nondiscrimination Notice

Fountain Point Surgery Center complies with applicable Federal civil rights laws and does not discriminate on the basis of age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation and gender identity or expression.  Fountain Point Surgery Center does not exclude people or treat them differently because of age, race, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, sexual orientation and gender identity or expression.  Our health plans are also subject to the section 1557 Nondiscrimination requirements and will be operated accordingly.

Fountain Point Surgery Center:

  • 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 Fountain Point Surgery Center's Civil Rights Coordinator at (402) 379-5555.

If you believe that Fountain Point Surgery Center 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:

Civil Rights Coordinator
Fountain Point Surgery Center
3901 W Norfolk Avenue, Suite L
Norfolk, NE 68701
(402) 379-5555 - Phone
(402) 379-5564 - Fax

You can file a grievance in person or by mail, fax or email.  If you need help filing a grievance, Fountain Point Surgery Center’s ADA Coordinator 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/smartscreen/main.jsf, or by mail or phone at:

U.S. Department of Health and Human Services
200 Independence Avenue, Southwest
Room 509F, HHH Building
Washington, D.C.  20201
(800) 368-1019, (800) 537-7697 (TDD)

Complaint forms are available at http://www.hhs.gov/ocr/filing-with-ocr/index.html.

Nondiscrimination Statement (English)

Language Assistance