Provides free aids and services to people with disabilities to communicate effectively with us, such as:

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1 Non-Discrimination Statement As a recipient of Federal financial assistance, Aegis Therapies complies with applicable Federal Civil Rights laws and does not exclude, deny benefits to, or otherwise discriminate against any person on the ground of race, color, national origin, religion, sex, gender, or on the basis of disability or age in admission to, participation in, or receipt of the services and benefits under any of its health programs and activities, and in staff and employee assignments to patients, whether carried out by Aegis Therapies directly or through a contractor or any other entity with which Aegis Therapies arranges to carry out its programs and activities. This statement is in accordance with the provisions of Title VI of the Civil Rights Act of 1964 (nondiscrimination on the basis of race, color, national origin), Section 504 of the Rehabilitation Act of 1973 (nondiscrimination on the basis of disability), the Age Discrimination Act of 1975 (nondiscrimination on the basis of age), Section 1557 of the Patient Protection and Affordable Care Act of 2010, 42 U.S.C , and regulations of the U.S. Department of Health and Human Services issued pursuant to these three statutes at Title 45 Code of Federal Regulations Parts 80, 84, 91, and 92. Aegis Therapies: Provides free aids and services to people with disabilities to communicate effectively with us, such as: o Qualified sign language interpreters o 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: o Qualified interpreters o Information written in other languages If you need these services, please contact the Section 1557 Coordinator listed below. In case of questions concerning this policy, or in the event of a desire to file a complaint alleging violations of the above, you may do so in person or by mail or telephone by contacting the Section 504/1557 Coordinator posted at the location in question or by contacting the Compliance Department at 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 or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW., Room 509F, HHH Building, Washington, DC 20201, , (TDD).

2 are available to you. Call ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (Arabic) 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) સ ચન : જ તમ ગ જર ત બ લત હ, ત ન:શ લ ક ભ ષ સહ ય સ વ ઓ તમ ર મ ટ ઉપલબ ધ છ. ફ ન કર (Gujarati) ध य न द : य द आप हद ब लत ह त आपक लए म फ त म भ ष सह यत स व ए उपलब ध ह पर क ल कर (Hindi) 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます まで お電話にてご連絡ください (Japanese) 주의 : 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수있습니다 ໂປດຊາບ: ຖ າວ າ ທ ານເວ າພາສາ ລາວ, ການບ ລ ການຊ ວຍເຫ ອດ ານພາສາ, ໂດຍບ ເສ ຽ ຄ າ, ແມ ນມ ພ ອມໃຫ ທ ານ. ໂທຣ (Laotian) ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para (Portuguese) al (Spanish) DİKKAT: Eğer Türkçe konuşuyor iseniz, dil yardımı hizmetlerinden ücretsiz olarak yararlanabilirsiniz irtibat numaralarını arayın. (Turkish) 2016 Version Alabama

3 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (Arabic) ध य न द : य द आप हद ब लत ह त आपक लए म फ त म भ ष सह यत स व ए उपलब ध ह पर क ल कर (Hindi) 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます まで お電話にてご連絡ください (Japanese) ՈՒՇԱԴՐՈՒԹՅՈՒՆ Եթե խոսում եք հայերեն, ապա ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ: Զանգահարեք (Armenian) توجه : اگر به زبان فارسی گفتگو می کنید تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با (Persian/Farsi) تماس بگیرید. ਧ ਆਨ ਦ ਓ: ਜ ਤ ਸ ਪ ਜ ਬ ਬ ਲਦ ਹ, ਤ ਭ ਸ਼ ਵ ਚ ਸਹ ਇਤ ਸ ਵ ਤ ਹ ਡ ਲਈ ਮ ਫਤ ਉਪਲਬਧ ਹ 'ਤ ਕ ਲ ਕਰ (Panjabi) របយ ត ប ស ន អ កន យ ខ រ, ស ជ ន យ ផ ក យម នគ តឈ ល គ ច នស ប ប រ អ ក ច រ ទ រស ព (Mon-Khmer/Cambodian) LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau (Hmong) เร ยน: ถ าค ณพ ดภาษาไทยค ณสามารถใช บร การช วยเหล อทางภาษาได ฟร โทร (Thai) California

4 al (Spanish). 주의 : 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수있습니다 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese). (رقم ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم ( Arabic )هاتف الصم والبكم UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer (Polish) સ ચન : જ તમ ગ જર ત બ લત હ, ત ન:શ લ ક ભ ષ સહ ય સ વ ઓ તમ ર મ ટ ઉપલબ ધ છ. ફ ન કર (Gujarati) ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero (Italian) ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para (Portuguese) ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele (Haitian Creole/French Creole) เร ยน: ถ าค ณพ ดภาษาไทยค ณสามารถใช บร การช วยเหล อทางภาษาได ฟร โทร (Thai) Florida

5 NOTICE: Language Assistance Available 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) ध य न द : य द आप हद ब लत ह त आपक लए म फ त म भ ष सह यत स व ए उपलब ध ह पर क ल कर (Hindi) 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます まで お電話にてご連絡ください (Japanese) توجه : اگر به زبان فارسی گفتگو می کنید تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با تماس بگیرید.( Persian/Farsi ) સ ચન : જ તમ ગ જર ત બ લત હ, ત ન:શ લ ક ભ ષ સહ ય સ વ ઓ તમ ર મ ટ ઉપલબ ધ છ. ફ ન કર (Gujarati) ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele (Haitian Creole/French Creole) ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች በነጻ ሊያግዝዎት ተዘጋጀተዋል ወደ ሚከተለው ቁጥር ይደውሉ (Amharic) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (Arabic) ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para (Portuguese) 2016 Version Georgia

6 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) ध य न द : य द आप हद ब लत ह त आपक लए म फ त म भ ष सह यत स व ए उपलब ध ह पर क ल कर (Hindi) 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます まで お電話にてご連絡ください (Japanese) رقم ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم ( Arabic )هاتف الصم والبكم Wann du [Deitsch (Pennsylvania Dutch)] schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff: Call (Pennsylvania Dutch) ਧ ਆਨ ਦ ਓ: ਜ ਤ ਸ ਪ ਜ ਬ ਬ ਲਦ ਹ, ਤ ਭ ਸ਼ ਵ ਚ ਸਹ ਇਤ ਸ ਵ ਤ ਹ ਡ ਲਈ ਮ ਫਤ ਉਪਲਬਧ ਹ 'ਤ ਕ ਲ ਕਰ (Panjabi) AANDACHT: Als u nederlands spreekt, kunt u gratis gebruikmaken van de taalkundige diensten. Bel (Dutch) သတ ပ ရန - အကယ သင သည မန မ စက က ပ ပ က ဘ သ စက အက အည အခမ သင အတ က စ စဥ ဆ င ရ က ပ ပ မည ဖ န န ပ တ သ ႔ ခၚဆ ပ (Burmese) Indiana

7 ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele (Haitian Creole/French Creole) 주의 : 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수있습니다 ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para (Portuguese) 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) (Vietnamese) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (Arabic) ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero (Italian) เร ยน: ถ าค ณพ ดภาษาไทยค ณสามารถใช บร การช วยเหล อทางภาษาได ฟร โทร (Thai) UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer (Polish) સ ચન : જ તમ ગ જર ત બ લત હ, ત ન:શ લ ક ભ ષ સહ ય સ વ ઓ તમ ર મ ટ ઉપલબ ધ છ. ફ ન કર (Gujarati) Iowa

8 Iowa

9 번으로전화해주십시오.(Korean) 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (Arabic) 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます まで お電話にてご連絡ください (Japanese) توجه: اگر به زبان فارسی گفتگو می کنید تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با تماس بگیرید.( Persian/Farsi ) LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau (Hmong) ໂປດຊາບ: ຖ າວ າ ທ ານເວ າພາສາ ລາວ, ການບ ລ ການຊ ວຍເຫ ອດ ານພາສາ, ໂດຍບ ເສ ຽ ຄ າ, ແມ ນມ ພ ອມໃຫ ທ ານ. ໂທຣ (Laotian) KUMBUKA: Ikiwa unazungumza Kiswahili, unaweza kupata, huduma za lugha, bila malipo. Piga simu (Swahili) သတ ပ ရန - အကယ သင သည မန မ စက က ပ ပ က ဘ သ စက အက အည အခမ သင အတ က စ စဥ ဆ င ရ က ပ ပ မည ဖ န န ပ တ သ ႔ ခၚဆ ပ (Burmese) Kansas

10 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) رقم ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم ( Arabic )هاتف الصم والبكم: 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます まで お電話にてご連絡ください (Japanese) OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su vam besplatno. Nazovite Telefon za osobe sa oštećenim govorom ili sluhom: (Serbo-Croatian/Serbian) Wann du [Deitsch (Pennsylvania Dutch)] schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff: Call (Pennsylvania Dutch) ध य न दन ह स : तप इ ल न प ल ब ल न न छ भन तप इ क न म त भ ष सह यत स व ह न श ल क पम उपलब ध छ फ न गन र ह स (Nepali) XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa (Cushite/Oromo) ICITONDERWA: Nimba uvuga Ikirundi, uzohabwa serivisi zo gufasha mu ndimi, ku buntu. Woterefona (Bantu/Kirundi) Kentucky

11 Note: Translated below ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call al (Spanish) 주의 : 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수있습니다 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) (Vietnamese) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (رقم هاتف الصم والبكم (Arabic) Звоните (Russian) nang walang bayad. Tumawag sa (Tagalog) ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para (Portuguese) ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች በነጻ ሊያግዝዎት ተዘጋጀተዋል ወደ ሚከተለው ቁጥር ይደውሉ (Amharic) Dè ɖɛ nìà kɛ dyéɖé gbo: Ɔ jǔ ké m [Ɓàsɔ ɔ -wùɖù-po-nyɔ ] jǔ ní, nìí, à wuɖu kà kò ɖò po-poɔ ɓɛ ìn m gbo kpáa. Ɖá (Kru, Ibo, Yoruba) خبردار: اگر آپ اردو بولتے ہیں تو آپ کو زبان کی مدد کی خدمات مفت میں دستیاب ہیں کال کریں (Urdu) 1 Appelez le (French) توجه : اگر به زبان فارسی گفتگو می کنید تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با ( Persian/Farsi )تماس بگیرید ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele (Haitian Creole/French Creole) સ ચન : જ તમ ગ જર ત બ લત હ, ત ન:શ લ ક ભ ષ સહ ય સ વ ઓ તમ ર મ ટ ઉપલબ ધ છ. ફ ન કર (Gujarati) Maryland

12 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (رقم هاتف الصم والبكم: (Arabic) របយ ត ប ស ន អ កន យ ខ រ, ស ជ ន យ ផ ក យម នគ តឈ ល គ ច នស ប ប រ អ ក ច រ ទ រស ព (Mon-Khmer/Cambodian) ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para (Portuguese) ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele (Haitian Creole/French Creole) ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero (Italian) ΠΡΟΣΟΧΗ: Αν μιλάτε ελληνικά, στη διάθεσή σας βρίσκονται υπηρεσίες γλωσσικής υποστήριξης, οι οποίες παρέχονται δωρεάν. Καλέστε (Greek) UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer (Polish) સ ચન : જ તમ ગ જર ત બ લત હ, ત ન:શ લ ક ભ ષ સહ ય સ વ ઓ તમ ર મ ટ ઉપલબ ધ છ. ફ ન કર (Gujarati) ध य न द : य द आप हद ब लत ह त आपक लए म फ त म भ ष सह यत स व ए उपलब ध ह पर क ल कर (Hindi) Massachusetts

13 주의 : 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수있습니다 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم رقم هاتف الصم والبكم: (Arabic) របយ ត ប ស ន អ កន យ ខ រ, ស ជ ន យ ផ ក យម នគ តឈ ល គ ច នស ប ប រ អ ក ច រ ទ រស ព (Cambodian) LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau (Hmong) XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa (Cushite/Oromo) ໂປດຊາບ: ຖ າວ າ ທ ານເວ າພາສາ ລາວ, ການບ ລ ການຊ ວຍເຫ ອດ ານພາສາ, ໂດຍບ ເສ ຽ ຄ າ, ແມ ນມ ພ ອມໃຫ ທ ານ. ໂທຣ (Laotian) ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች በነጻ ሊያግዝዎት ተዘጋጀተዋል ወደ ሚከተለው ቁጥር ይደውሉ (Amharic) ymol.ymo;= erh>uwdraund AusdmtCd<AerRM>Ausdmtw>rRpXRvXAwvXmbl.vXmphRAeDwrHRb.ohM. vdriaud; (Karen) Minnesota

14 are available to you. Call 번으로전화해주십시오 (Korean) 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (رقم هاتف الصم والبكم: (Arabic) Звоните ). (Russian) સ ચન : જ તમ ગ જર ત બ લત હ, ત ન:શ લ ક ભ ષ સહ ય સ વ ઓ તમ ર મ ટ ઉપલબ ધ છ. ફ ન કર (Gujarati) ANOMPA PA PISAH: [Chahta] makilla ish anompoli hokma, kvna hosh Nahollo Anompa ya pipilla hosh chi tosholahinla. Atoko, hattak yvmma im anompoli chi bvnnakmvt, holhtina pa payah: (Choctaw) 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます まで お電話にてご連絡ください (Japanese) ਧਆਨ ਦਓ: ਜ ਤ ਸ ਪ ਜ ਬ ਬ ਲਦ ਹ, ਤ ਭ ਸ਼ ਵ ਚ ਸਹ ਇਤ ਸ ਵ ਤ ਹ ਡ ਲਈ ਮ ਫਤ ਉਪਲਬਧ ਹ 'ਤ ਕ ਲ ਕਰ (Panjabi) ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero (Italian) ध य न द : यद आप ह द ब लत ह त आपक ल ए म फ त म भ ष सह यत स व ए उपलब ध ह पर क ल कर (Hindi) Mississippi

15 주의 : 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수있습니다 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (Arabic) Verfügung. Rufnummer (German) Wann du [Deitsch (Pennsylvania Dutch)] schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff: (Pennsylvania Dutch) توجه : اگر به زبان فارسی گفتگو می کنید تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با (Persian/Farsi) تماس بگیرید. XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa (Cushite/Oromo) ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para (Portuguese) ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች በነጻ ሊያግዝዎት ተዘጋጀተዋል ወደ ሚከተለው ቁጥር ይደውሉ (Amharic) OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su vam besplatno. Nazovite ) (Serbo-Croatian/Serbian) Missouri

16 Note: Translated below. ATTENTION: If you speak English, language assistance services, free of charge, al (Spanish) 주의 : 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수있습니다 번으로 전화해주십시오. (Korean) 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (رقم هاتف الصم والبكم: (Arabic) توجه: اگر به زبان فارسی گفتگو می کنید تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با تماس بگیرید. (Persian/Farsi) XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa (Cushite/Oromo) ymol.ymo;= erh>uwdraund AusdmtCd<AerRM>Ausdmtw>rRpXRvXAwvXmbl.vXmphRAeDwrHRb.ohM. vdriaud; (Karen) ध य न दन ह स : तप इ ल न प ल ब ल न न छ भन तप इ क न म त भ ष सह यत स व ह न श ल क पम उपलब ध छ फ न गन र ह स (Nepali) ໂປດຊາບ: ຖ າວ າ ທ ານເວ າພາສາ ລາວ, ການບ ລ ການຊ ວຍເຫ ອດ ານພາສາ, ໂດຍບ ເສ ຽ ຄ າ, ແມ ນມ ພ ອມໃຫ ທ ານ. ໂທຣ (Laotian) ي اگاداری: ي هگهر به زمانی کوردی قهسه دەکهیت خزمهتگوزاریهکانی یارمهتی زمان بهخۆڕایی بۆ تۆ بهردەسته. پهیوەندی به (Kurdish) 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます まで お電話にてご連絡ください (Japanese) Nebraska

17 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (رقم هاتف الصم والبكم: (Arabic) ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para (Portuguese) સ ચન : જ તમ ગ જર ત બ લત હ, ત ન:શ લ ક ભ ષ સહ ય સ વ ઓ તમ ર મ ટ ઉપલબ ધ છ. ફ ન કર (Gujarati) UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer (Polish) ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero (Italian) ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele (Haitian Creole/French Creole) ध य न द : य द आप हद ब लत ह त आपक लए म फ त म भ ष सह यत स व ए उपलब ध ह पर क ल कर (Hindi) خبردار: اگر آپ اردو بولتے ہیں تو آپ کو زبان کی مدد کی خدمات مفت میں دستیاب ہیں کال کریں (Urdu) 1 New Jersey

18 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (رقم هاتف الصم والبكم: (Arabic) 1 સ ચન : જ તમ ગ જર ત બ લત હ, ત ન:શ લ ક ભ ષ સહ ય સ વ ઓ તમ ર મ ટ ઉપલબ ધ છ. ફ ન કર (Gujarati) ध य न द : य द आप हद ब लत ह त आपक लए म फ त म भ ष सह यत स व ए उपलब ध ह पर क ल कर (Hindi) LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau (Hmong) របយ ត ប ស ន អ កន យ ខ រ, ស ជ ន យ ផ ក យម នគ តឈ ល គ ច នស ប ប រ អ ក ច រ ទ រស ព (Mon-Khmer/Cambodian) ໂປດຊາບ: ຖ າວ າ ທ ານເວ າພາສາ ລາວ, ການບ ລ ການຊ ວຍເຫ ອດ ານພາສາ, ໂດຍບ ເສ ຽ ຄ າ, ແມ ນມ ພ ອມໃຫ ທ ານ. ໂທຣ (Laotian) 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます まで お電話にてご連絡ください (Japanese) North Carolina

19 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (رقم هاتف الصم والبكم: (Arabic) Wann du [Deitsch (Pennsylvania Dutch)] schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff: Call (Pennsylvania Dutch) ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero (Italian) સ ચન : જ તમ ગ જર ત બ લત હ, ત ન:શ લ ક ભ ષ સહ ય સ વ ઓ તમ ર મ ટ ઉપલબ ધ છ. ફ ન કર (Gujarati) UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer (Polish) ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele (Haitian Creole/French Creole) របយ ត ប ស ន អ កន យ ខ រ, ស ជ ន យ ផ ក យម នគ តឈ ល គ ច នស ប ប រ អ ក ច រ ទ រស ព (Mon-Khmer/Cambodian) ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para (Portuguese) Pennsylvania

20 are available to you. Call al (Spanish) 주의 : 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수있습니다 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) ध य न दन ह स : तप इ ल न प ल ब ल न न छ भन तप इ क न म त भ ष सह यत स व ह न श ल क पम उपलब ध छ फ न गन र ह स (Nepali) OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su vam besplatno. Nazovite (Serbo-Croatian/Serbian) ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች በነጻ ሊያግዝዎት ተዘጋጀተዋል ወደ ሚከተለው ቁጥር ይደውሉ (Amharic) MAANDO: To a waawi [Adamawa], e woodi ballooji-ma to ekkitaaki wolde caahu. Noddu (Sudanic/Fulfulde) XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa (Cushite/Oromo) УВАГА! Якщо ви розмовляєте українською мовою, ви можете звернутися до безкоштовної служби мовної підтримки. Телефонуйте за номером (Ukrainian) ymol.ymo;= erh >uwdraund AusdmtCd <AerRM>Ausdmtw>rRpXRvXAwvXmbl.vXmphRAeDwrHRb.ohM. vdriaud ; (Karen). Notice pursuant to Section 1557 of Affordable Care Act South Dakota

21 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (Arabic) સ ચન : જ તમ ગ જર ત બ લત હ, ત ન:શ લ ક ભ ષ સહ ય સ વ ઓ તમ ર મ ટ ઉપલબ ધ છ. ફ ન કર (Gujarati) 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます まで お電話にてご連絡ください (Japanese) توجه: اگر به زبان فارسی گفتگو می کنید تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با تماس بگیرید.( Persian/Farsi ) ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች በነጻ ሊያግዝዎት ተዘጋጀተዋል ወደ ሚከተለው ቁጥር ይደውሉ (Amharic) ध य न द : य द आप हद ब लत ह त आपक लए म फ त म भ ष सह यत स व ए उपलब ध ह पर क ल कर (Hindi) ໂປດຊາບ: ຖ າວ າ ທ ານເວ າພາສາ ລາວ, ການບ ລ ການຊ ວຍເຫ ອດ ານພາສາ, ໂດຍບ ເສ ຽ ຄ າ, ແມ ນມ ພ ອມໃຫ ທ ານ. ໂທຣ (Laotian) Tennessee

22 al (Spanish) 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (Arabic) ध य न द : य द आप हद ब लत ह त आपक लए म फ त म भ ष सह यत स व ए उपलब ध ह पर क ल कर (Hindi) 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます まで お電話にてご連絡ください (Japanese) خبردار: اگر آپ اردو بولتے ہیں تو آپ کو زبان کی مدد کی خدمات مفت میں دستیاب ہیں کال کریں (Urdu) Appelez le (French) સ ચન : જ તમ ગ જર ત બ લત હ, ત ન:શ લ ક ભ ષ સહ ય સ વ ઓ તમ ર મ ટ ઉપલબ ધ છ. ફ ન કર (Gujarati) ໂປດຊາບ: ຖ າວ າ ທ ານເວ າພາສາ ລາວ, ການບ ລ ການຊ ວຍເຫ ອດ ານພາສາ, ໂດຍບ ເສ ຽ ຄ າ, ແມ ນມ ພ ອມໃຫ ທ ານ. ໂທຣ (Laotian) توجه : اگر به زبان فارسی گفتگو می کنید تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با (Persian/Farsi) تماس بگیرید. Texas

23 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) Appelez le (French) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم رقم هاتف الصم والبكم: (Arabic) توجه : اگر به زبان فارسی گفتگو می کنید تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با (Persian/Farsi) تماس بگیرید. ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች በነጻ ሊያግዝዎት ተዘጋጀተዋል ወደ ሚከተለው ቁጥር ይደውሉ (Amharic) خبردار: اگر آپ اردو بولتے ہیں تو آپ کو زبان کی مدد کی خدمات مفت میں دستیاب ہیں کال کریں (Urdu) ध य न द : य द आप हद ब लत ह त आपक लए म फ त म भ ष सह यत स व ए उपलब ध ह पर क ल कर (Hindi) লক ষ য কর ন যদ আপন ব ল, কথ বলত প র ন, ত হল ন খরচ য় ভ ষ সহ য ত পর ষ ব উপলব ধ আছ ফ ন কর ন ১ (Bengali) Dè ɖɛ nìà kɛ dyéɖé gbo: Ɔ jǔ ké m [Ɓàsɔ ɔ -wùɖù-po-nyɔ ] jǔ ní, nìí, à wuɖu kà kò ɖò po-poɔ ɓɛ ìn m gbo kpáa. Ɖá (Bassa) Virginia

24 주의 : 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수있습니다 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) (Vietnamese) ध य न दन ह स : तप इ ल न प ल ब ल न न छ भन तप इ क न म त भ ष सह यत स व ह न श ल क पम उपलब ध छ फ न गन र ह स (Nepali) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم (Arabic) 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます まで お電話にてご連絡ください (Japanese) ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero (Italian) เร ยน: ถ าค ณพ ดภาษาไทยค ณสามารถใช บร การช วยเหล อทางภาษาได ฟร โทร (Thai) توجه: اگر به زبان فارسی گفتگو می کنید تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با تماس بگیرید. (Persian/Farsi) خبردار: اگر آپ اردو بولتے ہیں تو آپ کو زبان کی مدد کی خدمات مفت میں دستیاب ہیں کال کریں (Urdu) West Virginia

25 . 주의 : 한국어를사용하시는경우, 언어지원서비스를무료로이용하실수있습니다 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese). (رقم ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم ( Arabic )هاتف الصم والبكم Wann du [Deitsch (Pennsylvania Dutch)] schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff: (Pennsylvania Dutch) ໂປດຊາບ: ຖ າວ າ ທ ານເວ າພາສາ ລາວ, ການບ ລ ການຊ ວຍເຫ ອດ ານພາສາ, ໂດຍບ ເສ ຽ ຄ າ, ແມ ນມ ພ ອມໃຫ ທ ານ. ໂທຣ (Laotian) UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer (Polish) ध य न द : य द आप हद ब लत ह त आपक लए म फ त म भ ष सह यत स व ए उपलब ध ह पर क ल कर (Hindi) KUJDES: Nëse flitni shqip, për ju ka në dispozicion shërbime të asistencës gjuhësore, pa pagesë. Telefononi në (Albanian) LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau (Hmong) Wisconsin

26 注意 : 如果您使用繁體中文, 您可以免費獲得語言援助服務 請致電 (Chinese) ملحوظة: إذا كنت تتحدث اذكر اللغة فا ن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقمرقم هاتف الصم والبكم: (Arabic) 注意事項 : 日本語を話される場合 無料の言語支援をご利用いただけます まで お電話にてご連絡ください (Japanese) Wann du [Deitsch (Pennsylvania Dutch)] schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff: (Pennsylvania/Dutch) XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa (Cushite/Oromo) ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero (Italian) AANDACHT: Als u nederlands spreekt, kunt u gratis gebruikmaken van de taalkundige diensten. Bel (Dutch) УВАГА! Якщо ви розмовляєте українською мовою, ви можете звернутися до безкоштовної служби мовної підтримки. Телефонуйте за номером (Ukrainian) ATENȚIE: Dacă vorbiți limba română, vă stau la dispoziție servicii de asistență lingvistică, gratuit. Sunați la (Romanian) Ohio

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