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Nondiscrimination Notice and Access to Communication Services 

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Empie Physicians Medical Group do not discriminate on the basis of sex, age, race, color, national origin, or disability. 

Free services are available to help you communicate with us. Such as, letters in other languages, or in other formats like large print. Or, you can ask for an interpreter. To ask for help, please call 1-760-770-8678 or Toll-Free: 1-800-414-5678.. TTY 711. 

If you think you weren’t treated fairly because of your sex, age, race, color, national origin, or disability, you can send a complaint to: 

Civil Rights Coordinator 
11000 Optum Circle 
Eden Prairie, MN 55344 
Fax:  855-351-5495  
Email:  Optum_Civil_Rights@Optum.com

If you need help with your complaint, please call the toll-free number 888-445-8745. TTY 711.  You must send the complaint within 60 days of when you found out about the issue. 

You can also file a complaint with the U.S. Dept. of Health and Human services.  
Online  https://ocrportal.hhs.gov/ocr/portal/lobby.jsf 
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html
Phone: Toll-free 1-800-368-1019, 800-537-7697 (TDD) 
Mail: U.S. Dept. of Health and Human Services. 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 

Language Assistance Services and Alternate Formats

This information is available in other formats like large print. To ask for another format, please call 1-760-770-8678 or Toll-Free: 1-800-414-5678.. TTY 711. 

ATTENTION: If you speak English, language assistance services, free of charge, are available to you.

Please call:

1-760-770-8678
Toll-Free: 1-800-414-5678.

ATENCIÓN: Si habla español (Spanish), hay servicios de asistencia de idiomas, sin cargo, a su disposición. Llame al1-760-770-8678 or Toll-Free: 1-800-414-5678..

請注意:如果您說中文 (Chinese),我們免費為您提供語言協助服務。請致電:1-760-770-8678 or Toll-Free: 1-800-414-5678.。

XIN LƯU Ý: Nếu quý vị nói tiếng Việt (Vietnamese), quý vị sẽ được cung cấp dịch vụ trợ giúp 

về ngôn ngữ miễn phí. Vui lòng gọi 1-760-770-8678 or Toll-Free: 1-800-414-5678..

알림: 한국어(Korean)를 사용하시는 경우 언어 지원 서비스를 무료로 이용하실 수 있습니

다.1-760-770-8678 or Toll-Free: 1-800-414-5678. 번으로 전화하십시오.

PAUNAWA: Kung nagsasalita ka ng Tagalog (Tagalog), may makukuha kang mga libreng serbisyo ng tulong sa wika. Mangyaring tumawag sa 1-760-770-8678 or Toll-Free: 1-800-414-5678..

ВНИМАНИЕ: бесплатные услуги перевода доступны для людей, чей родной язык 

является русском (Russian). Позвоните по номеру 1-760-770-8678 or Toll-Free: 1-800-414-5678..

.1-760-770-8678 or Toll-Free: 1-800-414-5678. ﻓﺈن ﺧﺪﻣﺎت اﻟﻤﺴﺎﻋﺪة اﻟﻠﻐﻮﯾﺔ اﻟﻤﺠﺎﻧﯿﺔ ﻣﺘﺎﺣﺔ ﻟﻚ. اﻟﺮﺟﺎء اﻷﺗﺼﺎل ﺑـ ،)Arabic(ﺗﻨﺒﯿﮫ: إذا ﻛﻨﺖ ﺗﺘﺤﺪث العربية

ATANSYON: Si w pale Kreyòl ayisyen (Haitian Creole), ou kapab benefisye sèvis ki gratis pou ede w nan lang pa w. Tanpri rele nan 1-760-770-8678 or Toll-Free: 1-800-414-5678..

ATTENTION : Si vous parlez français (French), des services d’aide linguistique vous sont proposés gratuitement. Veuillez appeler le 1-760-770-8678 or Toll-Free: 1-800-414-5678..

UWAGA: Jeżeli mówisz po polsku (Polish), udostępniliśmy darmowe usługi tłumacza. Prosimy zadzwonić pod numer 1-760-770-8678 or Toll-Free: 1-800-414-5678..

ATENÇÃO: Se você fala português (Portuguese), contate o serviço de assistência de idiomas gratuito. Ligue para 1-760-770-8678 or Toll-Free: 1-800-414-5678..

ATTENZIONE: in caso la lingua parlata sia l’italiano (Italian), sono disponibili servizi di assistenza linguistica gratuiti. Si prega di chiamare il numero 1-760-770-8678 or Toll-Free: 1-800-414-5678..

ACHTUNG: Falls Sie Deutsch (German) sprechen, stehen Ihnen kostenlos 

sprachliche Hilfsdienstleistungen zur Verfügung. Rufen Sie 1-760-770-8678 or Toll-Free: 1-800-414-5678. an.

注:日本語(日本語)を話す場合は、無料の言語サポートサービスを利用できます。 1-760-770-8678またはフリーダイヤル:1-800-414-5678までお電話ください。

 اﺳﺖ، ﺧﺪﻣﺎت اﻣﺪاد زﺑﺎﻧﯽ ﺑﮫ طﻮر راﯾﮕﺎن در اﺧﺘﯿﺎر ﺷﻤﺎ ﻣﯽ ﺑﺎﺷﺪ. )i sraF(ﺗﻮﺟﮫ: اﮔﺮ زﺑﺎن ﺷﻤﺎ فارسی   ﺗﻤﺎس ﺑﮕﯿﺮﯾﺪ.
1-760-770-8678 or Toll-Free: 1-800-414-5678.


कृपा धयान दें: यदद आप ह .दी (Hindi) भाषी हैं तो आपके िलए भाषा सहायता सेवाएं 

नन:शुिक उिप ध हैं। कृपा पर काि क रें 1-760-770-8678 or Toll-Free: 1-800-414-5678.

CEEB TOOM: Yog koj hais Lus Hmoob (Hmong), muaj kev pab txhais lus pub dawb rau koj. Thov 

hu rau 1-760-770-8678 or Toll-Free: 1-800-414-5678..

ចំណាប់អារម្មណ ៍ៈ  បេេេេបើសិនអ្នកនិយាយភាសាខ្ មមរ(Khmer)បសវាជំនួយភាសាបោយឥតគិតថ្ ៃល គឺមានសំរាប់អ្នក។ សូម្ទូរស័ព្ទ បៅបេម 1-760-770-8678 or Toll-Free: 1-800-414-5678.។

PAKDAAR: Nu saritaem ti Ilocano (Ilocano), ti serbisyo para ti baddang ti lengguahe nga awanan bayadna, ket sidadaan para kenyam. Maidawat nga awagan iti 1-760-770-8678 or Toll-Free: 1-800-414-5678..

DÍÍ BAA'ÁKONÍNÍZIN: Diné (Navajo) bizaad bee yániłti'go, saad bee áka'anída'awo'ígíí, t'áá jíík'eh, bee ná'ahóót'i'. T'áá shoodí kohjį'  1-760-770-8678 or Toll-Free: 1-800-414-5678. hodíilnih.

OGOW: Haddii aad ku hadasho Soomaali (Somali), adeegyada taageerada luqadda, oo bilaash ah, ayaad heli kartaa. Fadlan wa c1-760-770-8678 or Toll-Free: 1-800-414-5678..