LIFE PACE:

• Provides free aids and services to people with disabilities to communicate effectively with LIFE PACE, such as:

• Qualified sign languge interpreters

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

• Provides free language services to people whose primary language is not English, such as:

• Qualified Interpreters

• Information written in other languages

If you need these services, contact LIFE PACE's Privacy Officer. If you believe that LIFE PACE has failed to provide these services or discriminated in another way on the basis of race, ethnicity, national origin, religion, age, sex, mental or physical disability, sexual orientation or source of payment, you can file a grievance with: LIFE PACE, Privacy Officer, 5950 E. 31st St., Tulsa, OK, 74137, (918) 949-9969, TTY 7-1-1 and ask for (918) 949-9969, or Fax (918) 551-7982. You can file a grievance in person or by mail or fax. If you need help filing a grievance, our Privacy Officer 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/smartscreen/main.jsf, (you will leave the LIFE PACE web site) 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. (You will leave the LIFE PACE web site)

You have a right to all of this information in other languages. Please call us directly. We will work through an interpreter to discuss what materials you need in the language of your choice.