Circle of Life Hospice:
- Provides free aids and services, in a timely matter, 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 and other formats).
- Provides free language services, in a timely manner, to people whose primary language is not English, such as:
- Qualified interpreters
- Information written in other languages
If you need these services, contact Circle of Life’s Director of Clinical Services at 479-750-6632
If you believe that Circle of Life Hospice 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: Circle of Life’s Administrator at 901 Jones Rd. Springdale, AR 72762, Phone number 479-750-6632, Fax number 479-872-3379, Email email@example.com. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Circle of Life’s Administrator 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.