Deputy Director, Office of Civil Rights Department of Health Care Services Office of Civil Rights P.O. Box 997413, MS 0009 Sacramento, CA 95899-7413 Complaint forms are available at http://www .dhcs.ca.gov/Pages/Language_Access.aspx. y Electronically: Send an email to CivilRights@dhcs.ca.gov. OFFICE OF CIVIL RIGHTS – U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES If you believe you have been discriminated against on the basis of race, color, national origin, age, disability or sex, you can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights by phone, in writing, or electronically: y By phone: Call 1-800-368-1019. If you cannot speak or hear well, please call TTY/TDD 1-800-537-7697. y In writing: Fill out a complaint form or send a letter to: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 Complaint forms are available at http://www .hhs.gov/ocr/office/file/index.html. y Electronically: Visit the Office for Civil Rights Complaint Portal at https://ocrportal.hhs.gov/ ocr/portal/lobby.jsf. —Continued from the previous page TAGLINES TAGLINES English Tagline ATTENTION: If you need help in your language call 1-800-391-2000 (TTY: 711). Aids and services for people with disabilities, like documents in braille and large print, are also available. Call 1-800-391-2000 (TTY: 711). These services are free of charge. اﻟﺸﻌﺎر ﺔ ��� بﺎﻟﻌ (Arabic) �� ﻳُﺮ اﻻﻧتبﺎە: إذا اﺣﺘﺠﺖ � إ اﻟﻤﺴﺎﻋﺪة بﻠﻐﺘﻚ، ﻓﺎﺗﺼﻞ بـ 1-800-391-2000 (TTY: 711) . ﺗﺘﻮﻓﺮ ﺎ � ﻀ � أ اﻟﻤﺴﺎﻋﺪات واﻟﺨﺪﻣﺎت ﻟﻸﺷﺨﺎص ذوي اﻹﻋﺎﻗﺔ، ﻣﺜﻞ اﻟﻤﺴتﻨﺪات ﺔ �� اﻟﻤﻜﺘ ﻘﺔ �� بﻄ ﻞ �� ﺑ واﻟﺨﻂ ي . � ﺒ � اﻟ اﺗﺼﻞ بـ 1-800-391-2000 .(TTY: 711) ﻫﺬە اﻟﺨﺪﻣﺎت ﺔ . � ﻣﺠﺎﻧ Հայերեն պիտակ (Armenian) ՈՒՇԱԴՐՈՒԹՅՈՒՆ: Եթե Ձեզ օգնություն է հարկավոր Ձեր լեզվով, զանգահարեք 1800-391-2000 (TTY: 711)։ Կան նաև օժանդակ միջոցներ ու ծառայություններ հաշմանդամություն ունեցող անձանց համար, օրինակ` Բրայլի գրատիպով ու խոշորատառ տպագրված նյութեր։ Զանգահարեք 1-800-391-2000 (TTY: 711)։ Այդ ծառայություններն անվճար են։ �� ស�� ល់���ែខ� រ (Cambodian) ចំ�ំ៖ េបើ អ�ក ្រតវ� �រជំនួយ ��� របស់អ� ក សូម ទូរស័ព� េ�េលខ 1-800-391-2000 (TTY: 711)។ ជំនួយ និង េស�កម� ស្រ�ប់ ជនពិ�រ ដូច�ឯក�រសរេសរ�អក្សរផុស ស្រ�ប់ជនពិ�រែភ� ក ឬឯក�រសរេសរ�អក្សរពុម� ធំ ក៏�ចរក�នផងែដរ។ ទូរស័ព� មកេលខ 1-800-391-2000 (TTY: 711)។ េស�កម� �ំងេនះមិនគិតៃថ� េឡយើ ។ 简体中文标语 (Chinese) 请注意：如果您需要以您的母语提供帮助，请致电 1-800-391-2000 (TTY: 711)。另外还
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