312016Oct

Notice of Non-Discrimination

Notice of Nondiscrimination

Life Source Services (“LSS”) complies complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. LSS does not exclude people or treat them differently because of race, color, national origin, age, disability or sex.

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

    • Qualified sign language interpreters
    • Information written in other languages

If you need these services, contact LSS’s Administrator at the phone number, mail, or email listed below.

If you believe that LSS 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:

LSS – Administrator
ATTN: Ms. D’Imperio
230 E. Ridgewood Ave. #307
Paramus, NJ 07652
Phone: 1-888-865-5103
Email: contact@lifesourcehospice.com

You can file a grievance in person, by mail, or email. If you need help filing a grievance, LSS 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:

Office for Civil Rights Headquarters
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019 or 1-800-537-7697 (TDD)

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