Notice of Nondiscrimination

Nondiscrimination Statement

Holly Hill Pharmacy complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Holly Hill Pharmacy does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Accessibility and Accommodations

Holly Hill Pharmacy provides:

• Reasonable modifications to policies and procedures when necessary to ensure equal access for individuals with disabilities.
• Auxiliary aids and services, free of charge, to people with disabilities to enable effective communication, including:
  • Qualified sign language interpreters
  • Written information in other formats (large print, audio, accessible electronic formats, and other formats upon request)
• Language assistance services, free of charge, to people whose primary language is not English, including:
  • Qualified interpreters
  • Information written in other languages

If you need these services, please contact Holly Hill Pharmacy at 386-677-7377.

How to File a Grievance

If you believe that Holly Hill Pharmacy has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you may file a grievance with:

You may file a grievance in person, by mail, by fax, or by phone. If you need help filing a grievance, our Compliance Officer is available to assist you.

Filing a Complaint with the U.S. Department of Health and Human Services

You may 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, or by mail or phone at:

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

Language Assistance Services

ATTENTION: If you speak a language other than English, language assistance services are available to you free of charge. Call 386-677-7377.

Spanish: ATENCION: si habla espanol, tiene a su disposicion servicios gratuitos de asistencia linguistica. Llame al 386-677-7377.

Haitian Creole: ATANSYON: Si w pale Kreyol Ayisyen, gen sevis ed pou lang ki disponib gratis pou ou. Rele 386-677-7377.

French: ATTENTION: Si vous parlez francais, des services d'aide linguistique vous sont proposes gratuitement. Appelez le 386-677-7377.

Portuguese: ATENCAO: Se fala portugues, encontram-se disponiveis servicos linguisticos, gratis. Ligue para 386-677-7377.

Vietnamese: CHU Y: Neu ban noi Tieng Viet, co cac dich vu ho tro ngon ngu mien phi danh cho ban. Goi so 386-677-7377.

Chinese: zhu yi: ru guo nin shi yong fan ti zhong wen, nin ke yi mian fei huo de yu yan yuan zhu fu wu. Qing zhi dian 386-677-7377.

Section 1557 of the Affordable Care Act

This notice is provided pursuant to Section 1557 of the Affordable Care Act (42 U.S.C. 18116), which prohibits discrimination in health programs and activities receiving federal financial assistance. Holly Hill Pharmacy is committed to full compliance with Section 1557 and all applicable federal and state civil rights laws and regulations.

Contact Us

For questions about this Notice of Nondiscrimination, or to request accommodations or language assistance, please contact: