Notice of Privacy Practices

Information written in other languagesIf you need these services, contact the Administrator.

If you believe that Rose City Urology has 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 Administrator, 4293 Kinsey Drive, Tyler, Texas 75703, Phone: 903-690-7775, Fax: 903-690-7825. You can file a grievance in person or by mail or fax. If you need help filing a grievance, the Administrator 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/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)

Written information in other formats (large print, audio, accessible electronic formats, other formats)
Rose City Urology provides free language services to people whose primary language is not English, such as: