text: ENGLISHNorth Country Hospital complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. North Country Hospital does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. Attention: You have the right to an interpreter at no cost to you. North Country 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 languagesIf you need these services, contact Thom Goodwin. If you believe that North Country Hospital 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: Thom Goodwin – Director of Quality and Patient Care, 189 Prouty Drive, Newport, VT, 05855, 802-334-3295, 800-253-0191, . You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Thom Goodwin – Director of Quality and Patient Care 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 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 
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text: ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. North Country Hospital respecte les lois fédérales en vigueur relatives aux droits civiques et ne pratique aucune discrimination basée sur la race, la couleur de peau, l’origine nationale, l’âge, le sexe ou un handicap. [Name of covered entity] n’exclut et ne traite aucune personne différemment en raison de sa race, sa couleur de peau, son origine nationale, son âge, son sexe ou son handicap. North Country Hospital: • Fournit gratuitement des aides et services aux personnes handicapées afin de permettre une communication efficace avec nous, par exemple: ○ Interprètes qualifiés en langue des signes ○ Informations écrites dans d’autres formats (gros caractères, audio, formats électroniques accessibles, autres formats) • Fournit gratuitement des services linguistiques aux personnes dont la langue principale n’est pas l’anglais, par exemple : ○ Interprètes qualifiés ○ Informations écrites dans d’autres langues Si vous avez besoin de ces services, contactez Thom Goodwin Si vous pensez que North Country Hospital n’a pas fourni ces services ou a fait preuve d’une autre forme de discrimination basée sur la race, la couleur de peau, l’origine nationale, l’âge, le sexe ou le handicap, vous pouvez déposer une réclamation auprès de : Thom Goodwin – Director of Quality and Patient Care, 189 Prouty Drive, Newport, VT, VT, 05855, 802-334-3295, 800-253-0191, . Vous pouvez déposer une réclamation en personne ou par courrier, télécopie ou e-mail. Si vous avez besoin d’aide pour déposer une réclamation Thom Goodwin – Director of Quality and Patient Care se tient à votre disposition pour vous y aider. Vous pouvez également déposer une réclamation concernant vos droits civiques auprès de l’U.S. Department of Health and Human Services (Département de la Santé et des Services Sociaux des États-Unis), Office for Civil Rights (Bureau des Droits Civiques), par voie électronique via l’Office for Civil Rights Complaint Portal, disponible à l’adresse par courrier ou par téléphone à : 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) Des formulaires de réclamation sont disponibles à l’adresse 
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text: ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. North Country Hospital cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. North Country Hospital no excluye a las personas ni las trata de forma diferente debido a su origen étnico, color, nacionalidad, edad, discapacidad o sexo. North Country Hospital : • Proporciona asistencia y servicios gratuitos a las personas con discapacidades para que se comuniquen de manera eficaz con nosotros, como los siguientes: ○ Intérpretes de lenguaje de señas capacitados. ○ Información escrita en otros formatos (letra grande, audio, formatos electrónicos accesibles, otros formatos). • Proporciona servicios lingüísticos gratuitos a personas cuya lengua materna no es el inglés, como los siguientes: ○ Intérpretes capacitados. ○ Información escrita en otros idiomas. Si necesita recibir estos servicios, comuníquese con Thom Goodwin. Si considera que North Country Hospital no le proporcionó estos servicios o lo discriminó de otra manera por motivos de origen étnico, color, nacionalidad, edad, discapacidad o sexo, puede presentar un reclamo a la siguiente persona: Thom Goodwin – Director of Quality and Patient Care, 189 Prouty Drive, Newport, VT, VT, 05855, 802-334-3295, 800-253-0191, . Puede presentar el reclamo en persona o por correo postal, fax o correo electrónico. Si necesita ayuda para hacerlo, réclamation Thom Goodwin – Director of Quality and Patient Care está a su disposición para brindársela. También puede presentar un reclamo de derechos civiles ante la Office for Civil Rights (Oficina de Derechos Civiles) del Department of Health and Human Services (Departamento de Salud y Servicios Humanos) de EE. UU. de manera electrónica a través de Office for Civil Rights Complaint Portal, disponible en o bien, por correo postal a la siguiente dirección o por teléfono a los números que figuran a continuación: 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) Puede obtener los formularios de reclamo en el sitio web 
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text: ध्या दाहु ोस:् तपयइल े ाेपयल बोलाहु ुुन भाे तपयइक ो मत भयषयसहय्तयसेवयहरशलु करपपयउपलब्न North Country Hospital ले उपयुक्त संघीय अधकारको व्यवस्थासँगै पालन गछर् र वंश, रङ, रािष्ट्रयता, उमेर, अपाङ्गता वा लङ्गको आधारमा भेदभाव गदन । North Country Hospital ले वंश, रङ, रािष्ट्रयता, उमेर, अपाङ्गता वा लङ्गको कारण मानसहरूलाइर् भन्न रूपले व्यवहार वा मानसहरूलाइर् बेवास्ता गदन । North Country Hospital : • यसले हामीसँग प्रभावकार रूपमा संचार गनर् अपाङ्गता भएका मानसहरूलाइर् नःशल्ु क सहायता र सेवाहरू प्रदान गछर्, जस्तैः o योग्य साङ्के तक भाषा अनवु ाद गनहरू o अन्य ढाँचाहरूमा लखत जानकार (ठूलो प्रन्ट, अडयो, सिजलै पहुँच भएको इलेक्ट्रोनक ढाँचाहरू, अन्य ढाँचाहरू) • प्राथमक भाषा अङ्ग्रेजी नभएका मानसहरूलाइर् नःशल्ु क भाषाका सेवाहरू प्रदान गन, जस्तैः o योग्य अनवु ादकहरू o अन्य भाषाहरूमा लखत जानकार तपाइलाइर् यी सेवाहरू आवश्यक छ भने Thom Goodwin मा सम्पकर् गनहुर् ोस् North Country Hospital ले यी सेवाहरू प्रदान गनर् असफल भएको छ अथवा वशं , रङ, रािष्ट्रयता, उमेर, अपाङ्गता वा लङ्गको आधारमा अन्य तरकामा भेदभाव गरेको छ भनेर तपाइले वश्वास गनहुर् ुन्छ भने तपाइले गनु ासो गनर् सक्नहु ुन्छः Thom Goodwin – Director of Quality and Patient Care, 189 Prouty Drive, Newport, VT, VT, 05855, 802-334-3295, 800-253-0191, । तपाइले पत्र,फ्याक्स वा इमेलबाट वा व्यिक्तगत रूपमा गनु ासो गनर् सक्नहु ुन्छ । गुनासो गनर् तपाइलाइर् सहायताको खाँचो छ भने Thom Goodwin – Director of Quality and Patient Care मा तपाइलाइर् सहायता उपलब्ध छ । तपाइले Office for Civil Rights (नागरक अधकारको कायार्लय), U.S. Department of Health and Human Services (य.ु एस. स्वास्थ्य र मानव सेवा वभाग) सँग नागरक अधकारको गुनासो दतार् पन गनर् सक्नुहुन्छ, Office for Civil Rights Complaint Portal को निम्त कायालर् यबाट इलेक्ट्रोनक रूपमा मा वा पत्र वा फोनबाट यहाँ उपलब्ध छः 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 (टडड) गनु ासो फाराम मा उपलब्ध छन् ।OBAVJEŠTENJE: Ako govorite srpsko- hrvatski, usluge jezičke pomoći dostupne su vam besplatno.Srpsko-hrvatskiNorth Country Hospital pridržava se važećih saveznih zakona o građanskim pravima i ne pravi diskriminaciju po osnovu rase, boje kože, nacionalnog porijekla, godina starosti, invaliditeta ili pola. [Name of covered entity] ne isključuje ljudi niti ih tretira drugačije zbog njihove rase, boje kože, nacionalnog porijekla, godina starosti, invaliditeta ili pola. North Country Hospital: • Pruža besplatnu pomoć i usluge osobama sa invaliditetom kako bi komunicirali efikasno s nama, poput: ○ kvalifikovanih tumača za znakovni jezik ○ pisanih informacija u drugim formatima (veća slova štampanih materijala, audio format, dostupni elektronski i drugi formati) • Pruža besplatne jezičke usluge osobama čiji maternji jezik nije engleski, poput: ○ kvalifikovanih jezičkih tumača ○ informacija napisanih na drugim jezicima Ako su vam potrebne ove usluge, kontaktirajte Thom Goodwin. Ako mislite da vam North Country Hospital nije pružio ove usluge ili ste bili izloženi diskriminaciji na neki drugi način po osnovu rase, boje kože, nacionalnog porijekla, godina starosti, invaliditeta ili pola, možete podnijeti prigovor sljedećoj ustanovi: Thom Goodwin – Director of Quality and Patient Care, 189 Prouty Drive, Newport, VT, VT, 05855, 802-334-3295, 800-253-0191, . Prigovor možete podnijeti lično, poštom, faksom ili elektronskom poštom. Ako vam je potrebna pomoć za podnošenje prigovora, Thom Goodwin – Director of Quality and Patient Care je dostupan da vam pomogne. Takođe možete podnijeti žalbu u vezi građanskih prava ministarstvu U.S. Department of Health and Human Services (Ministarstvo zdravlja i socijalnih usluga), Office for Civil Rights (Služba za građanska prava) elektronski preko Office for Civil Rights Complaint Portal, dostupnog na ili poštom ili telefonom na: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-868-1019, 800-537-7697 (TDD – Telefon za osobe sa oštećenim govorom ili sluhom) Obrasci žalbe dostupni su na 
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text: XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. North Country Hospital seera hawwaasummaa Feederaalaan kan wal simu ta’ee sanyii, bifa, dhiigaan, uumriidhaan, yookiin koorniyaadhaan kan wal hin loognee dha. North Country Hospital namoota yookiin sanyii sanyiidhaan, bifaan, dhiigaan, umriidhaan, hir’ina qaamaan yookiin koorniyaadhaan adda hin baasu. North Country Hospital : •Namootni hir’ina garaagaraa qaban bifa gaarii ta’een nu waliin haasa’uu akka danda’aniif deeggarsa fi tajaajila tolaa kennaafii, kanneen akka: ○ Namoota afaan mallattoo haalaan hiikkuu danda’an ○ Odeeffannoo barreeffamaa foormaatii adda ta’een (barreeffama guddaadhaan, sagaleedhaan, foormaatii eleektirooniksii argamuu danda’uun, foormaatii biroo) •Namoota afaan dhalootaa isaanii afaan Ingiliffaa hin taaneef tajaajila afaanii tolaa dhiheessuufi, kanneen akkaL: ○ Warra dandeettii afaan hiikuu gahaa ta’e qaban ○ Odeeffannoo afaanota birootiin barraahe Tajaajila kana yoo barbaadde, Thom Goodwin qunnamaa Kana yoo itti amante North Country Hospital tajajila kana kennuudhaaf hin dandeenye yookiin tajaajila kana kennuu hin dandeenye yookiin sanyiidhaan ,bifaan, dhiigaan, umriidhaan, hiri’ina qaamaan, ykn koorniyaadhaanii fi kanneen birootiin looguu, komii keessan kanneen armaan gadiitiin dhiheessuu ni dandeessu: Thom Goodwin – Director of Quality and Patient Care, 189 Prouty Drive, Newport, VT, VT, 05855, 802-334-3295, 800-253-0191, . Komii namaan, yookiin poostaadhaan, faaksiidhaan, yookiin e-mail dhaan dhiheessuu ni dandeessa. Komii guutuudhaaf gargaarsa yoo barbaadde Thom Goodwin – Director of Quality and Patient Care si gargarudhaaf qophii dha. Komiiwwan mirga namoomaa U.S. Department of Health and Human Services (Kutaa Fayyaa fi Tajaajila Namoomaa U.S), Office for Civil Rights (Waajjira Mirga Hawwaasummaa) eleektirooniksiidhaan the Office for Civil Rights Complaint Portal, kunis kan argamu ykn poostaadhaan yookiin bilbilaan : U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-868-1019, 800-537-7697 (TDD) Foormiin komiidhaa kan argamu irratti dha.
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text: ItalianoATTENZIONE: In caso la lingua parlata sia l’italiano, sono disponibili servizi di assistenza linguistica gratuiti. North Country Hospital è conforme a tutte le leggi federali vigenti in materia di diritti civili e non pone in essere discriminazioni sulla base di razza, colore, origine nazionale, età, disabilità o sesso. North Country Hospital non esclude le persone o le tratta diversamente a causa di razza, colore, origine nazionale, età, disabilità o sesso. North Country Hospital : • Offre sostegni e servizi gratuiti alle persone affette da disabilità per comunicare con noi in modo efficace, quali: ○ Interpreti qualificati nella lingua dei segni ○ Informazioni scritte in altri formati (stampe a grandi caratteri, audio, formati elettronici accessibili, altri formati) • Offre servizi linguistici gratuiti alle persone la cui lingua primaria non è l’inglese, quali: ○ Interpreti qualificati ○ Informazioni scritte in altre lingue In caso si necessiti di tali servizi, contattare Thom Goodwin. In caso si ritenga che North Country Hospital non abbia offerto tali servizi o abbia posto in essere discriminazioni in altri modi sulla base di razza, colore, origine nazionale, età, disabilità o sesso, è possibile presentare una vertenza a Thom Goodwin – Director of Quality and Patient Care, 189 Prouty Drive, Newport, VT, VT, 05855, 802-334-3295, 800-253-0191, . È possibile presentare una vertenza di persona o a mezzo posta, fax oppure e-mail. In caso si necessiti di aiuto per la presentazione della vertenza, Thom Goodwin – Director of Quality and Patient Care è disponibile a fornire assistenza. È altresì possibile presentare un reclamo per i diritti civili allo U.S. Department of Health and Human Services (Dipartimento statunitense per la salute e i servizi umani), Office for Civil Rights (Ufficio per i diritti civili), elettronicamente mediante il Office for Civil Rights Complaint Portal, disponibile all’indirizzo oppure a mezzo posta o telefono all’attenzione di: 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) I moduli di reclamo sono disponibili all’indirizzo 
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text: العربيةنإف ،ةغللا ركذا ثدحتت تنك اذإ :ةظوحلم .ناجملاب كل رفاوتت ةیوغللا ةدعاسملا تامدخ يلتزم North Country Hospital بقوانين الحقوق المدنية الفدرالية المعمول بها ولا يميز على أساس العرق أو اللون أو الأصل الوطني أو السن أو الإعاقة أو نوع الجنس. لا يستبعد North Country Hospital الأشخاص أو يعاملهم على نحو مختلف بسبب النوع أو اللون أو الأصل الوطني أو السن أو الإعاقة أو نوع الجنس. North Country Hospital: • يوفر مساعدات وخدمات مجانية للأشخاص من ذوي الإعاقات للتواصل بصورة فعالة معنا، مثل: ○ مترجمي لغة إشارة مؤهلين ○ معلومات كتابية بتنسيقات أخرى (مطبوعة بأحرف كبيرة، مواد صوتية، تنسيقات إلكترونية متيسرة، وغير ذلك من التنسيقات) • يوفر خدمات لغوية مجانية للأشخاص الذين لغتهم الأساسية ليست الإنجليزية، مثل: ○ مترجمين مؤهلين ○ معلومات مكتوبة بلغات أخرى إذا كنت بحاجة لهذه الخدمات، اتصل بـ Thom Goodwin إذا كنت تعتقد أن North Country Hospital قد أخفق في توفير تلك الخدمات أو ميز بطريقة أخرى على أساس العرق أو اللون أو الأصل الوطني أو السن أو الإعاقة أو الجنس، يمكن أن تتقدم بشكوى إلى: Thom Goodwin – Director of Quality and Patient Care, 189 Prouty Drive, Newport, VT, VT, 05855, 802-334-3295, 800-253-0191, . يمكن أن تتقدم بشكوى شخصيًا أو بالبريد أو بالفاكس أو البريد الإلكتروني. إذا كنت بحاجة للمساعدة في التقدم بشكوى، فإنThom Goodwin – Director of Quality and Patient Care متاح لمساعدتك. يمكن أيضًا أن تتقدم بشكوى إلكترونيًا لوزارة Department of Health and Human Services (وزارة الخدمات الصحية والبشرية) ، مكتب Office for Civil Rights (مكتب الحقوق المدنية)، من خلال مكتب Office for Civil Rights Complaint Portal، المتوفر على الرابط أو بالبريد أو الهاتف على: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 1-800-863-1019, 800-537-7697 (رقم هاتف الصم والبكم) تتوافر نماذج الشكاوى على الرابط РусскийВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода.TagalogPAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad.PortuguêsATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis.日本語注意事項:日本語を話される場合、無料 の言語支援をご利用いただけます。ภาษาไทยเรี ยน: ถา้ คุณพดู ภาษาไทยคุณสามารถใชบ้ ริการช่วยเหลือทางภาษ า ไ ด ฟ้ ร
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