Notice of Non-Discrimination

J2 Therapy and Wellness Patients

• Appendix A to Part 92—Sample Notice Informing Individuals About Nondiscrimination and Accessibility Requirements and Sample Nondiscrimination Statement: Discrimination is Against the Law

• J2 Therapy and Wellness LLCcomplies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. J2 Therapy and Wellnessdoes not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. 

• J2 Therapy and Wellness 

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

• Written information in other formats (large print, accessible electronic formats when available, other formats)

• Reasonably provides free language services to people whose primary language is not English and whose primary language is one of the top 3 most commonly spoken languages in Loudoun County, VA according to official county census, such as:

• Use of internet translators (example: Google Translate) for verbal and/or written communication

• If you need these services, please request them upon scheduling your appointment with J2 Therapy & Wellness LLC.

• If you believe that J2 Therapy and Wellnesshas 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 the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available athttps://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
  
  Statement of Non-Discrimination

• English

• J2 Therapy and Wellness complies with applicable Federal civil rights laws and does not discriminate on the

• basis of race, color, national origin, age, disability, or sex.

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• Espanol (Spanish)

• J2 Therapy and Wellness cumple con las leyes federales de derechos civiles aplicables y no discrimina por

• motivos de raza, color, nacionalidad, edad, discapacidad o sexo.

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• 한국어(Korean)

• J2 Therapy and Wellness 은(는)관련연방공민권법을준수하며인종,피부색,출신국가,연령,장애또는

• 성별을이유로차별하지않습니다.

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• Tagalog (Tagalog - Filipino)

• Sumusunod ang J2 Therapy and Wellness sa mga naaangkop na Pederal na batas sa karapatang sibil at

• hindi nandidiskrimina batay sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian.

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• Tiếng Việt (Vietnamese)

• J2 Therapy and Wellness tuân thủ luật dân quyền hiện hành của Liên bang và không phân biệt đối xử dựa

• trên chủng tộc, màu da, nguồn gốc quốc gia, độ tuổi, khuyết tật, hoặc giới tính.

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• 繁體中文(Chinese)

• J2 Therapy and Wellness 遵守適用的聯邦民權法律規定，不因種族、膚色、民族血統、年齡、殘障或性別而

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  हिंदी(Hindi)

• 
  जे2थेरेपीऔरकल्याणलागूसंघीयनागरिकअधिकारकानूनोंकाअनुपालनकरताहैऔरइसपरभेदभावनहींकरताहैजाति,रंग,राष्ट्रीयमूल,आयु,अक्षमता,यालिंगकाआधार
  
  Language Assistance Services

• English

• ATTENTION: If you speak one of the following languages, language assistance services, free of charge, are

• available to you within reason and within the capabilities of this company. Please contact J2 Therapy and Wellness LLC.

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• Espanol (Spanish)

• ATENCIÓN: si habla uno de los siguientes idiomas, los servicios de asistencia lingüística son gratuitos. disponible para usted dentro de lo razonable y dentro de las capacidades de esta compañía. Por favor, póngase en contacto con J2 Therapy and Wellness LLC.

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• 한국어(Korean)
  주의: 다음중하나의언어를사용하는경우무료로언어지원서비스를이용할수있습니다.이회사의이성과능력내에서귀하에게제공됩니다. J2 Therapy and Wellness LLC에연락하십시오.

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• Tagalog (Tagalog - Filipino)

• Pansinin: Kung nagsasalita ka ng isa sa mga sumusunod na wika, ang mga serbisyo ng tulong sa wika, nang libre na magagamit mo sa loob ng dahilan at sa loob ng mga kakayahan ng kumpanyang ito. Mangyaring makipag-ugnay sa J2 Therapy and Wellness LLC.

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• Tiếng Việt (Vietnamese)

• CHÚ Ý: Nếu bạn nói một trong những ngôn ngữ sau, dịch vụ hỗ trợ ngôn ngữ, miễn phí, làcó sẵn cho bạn trong phạm vi lý do và trong khả năng của công ty này. Vui lòng liên hệ với J2 Therapy and Wellness LLC.

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• 繁體中文(Chinese)

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  注意：如果您使用以下语言之一，则免费提供语言协助服务在合理的范围内，在公司的能力范围内为您服务。请联系J2 Therapy and Wellness LLC。

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• हिंदी(Hindi)

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  सावधानी:यदिआपनिम्नलिखितभाषाओंमेंसेएकबोलतेहैं,तोभाषासहायतासेवाएंनि:शुल्कहैंकारणकेभीतरऔरइसकंपनीकीक्षमताओंकेभीतरआपकेलिएउपलब्धहै।कृपयाजे2थेरेपीऔरवेलनेसएलएलसीसेसंपर्ककरें।