warning

Due to HIPAA guidelines,

we cannot accept any forms or discuss any health information
by email.

Please bring all your forms with you to the appointment 

warning

Debido a las pautas de HIPAA,

No podemos aceptar ninguna forma o discutir cualquier información de salud
por correo electrónico.

Por favor traiga todos sus formularios con usted a la cita

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DISCLOSURE LETTER

CARTA DE REVELACION

To All Our Patients

As required by California Business and Professions Code Section 650.01 and 650.02, this notice is to inform you that We have ownership interest in Euclid Endoscopy Center .

We maintain this interest in order to ensure that we provide the highest quality services at competitive prices.

There may be other organizations from which you can obtain these services.  You should consult the Yellow Pages of a local phone directory if you wish to obtain the names of such alternative organizations.

Sincerely,

Taddese Desta, M.D.                                                Carlton Thomas, M.D.

Cynthia Schaeffer, M.D.                                            Ivan Cubas, M.D.

A todos nuestros pacientes

El codigo de Negocios y Profesiones del estado de California Sección 650,01 y 650,02, ordena que esta nota sea presentada para informarle que somos propietarios de “Euclid Endoscopy Center.”

Mantenemos este interés para asegurar que proporcionamos los servicios de la mas alta calidad a precios competitivos.

Es posible que existan otras organizaciones en las que usted puede obtener estos servicios. Puede consultar las Páginas de las seccion Amarilla de una guía local de teléfono si usted desea obtener los nombres de tales organizaciones.

Sinceramente,

Taddese Desta, M.D.                                                Carlton Thomas, M.D.

Cynthia Schaeffer, M.D.                                            Ivan Cubas, M.D.

EUCLID ENDOSCOPY CENTER

286 Euclid Avenue, Suite 109 | San Diego, CA 92114 | 619-564-8249

Discrimination is Against the Law.

Euclid Endoscopy Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Euclid Endoscopy Center does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Euclid Endoscopy Center:

  • Provides free aids and services to people with disabilities to communicate effectively with us, such as:
    • Qualified sign language 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 our Civil Rights Coordinator.
If you believe that Euclid Endoscopy Center 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:

Alejandro Campos
Euclid Endoscopy Center
286 Euclid Avenue, Suite 109
San Diego, CA 92114
Phone: 619-564-8249
Fax: 619-564-8236
Email: info@eecsd.com

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:
U.S. Dept. of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201

or phone at:
1-800-368-1019, 800-537-7697 (TDD)

Complaint forms are available at:
http://www.hhs.gov/ocr/office/file/index.html.

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