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The above-listed Practice complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
The Practice does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
- 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, accessible electronic formats)
- Provides free language services to people whose primary language is not English, such as:
- Qualified interpreters
- Informed consent forms available in Spanish
If you need these services, contact the Practice’s Office Manager (the “Civil Rights Coordinator”).
If you believe that the Practice 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 Practice’s Civil Rights Coordinator pursuant to the above-listed contact information.
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the Practice’s Civil Rights Coordinator 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, or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue S.W.
Room 509F, HHH Building
Washington, DC 20201
Toll Free: 1-800-868-1019
Complaint forms are available at https://www.hhs.gov/ocr/complaints/index.html.