NON-DISCRIMINATION NOTICE
OCR NOTICE OF NONDISCRIMINATION

NON-DISCRIMINATION NOTICE

OCR NOTICE OF NONDISCRIMINATION

Source: HHS Office for Civil Rights

Oral and Maxillofacial Surgeons of Utah
complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

Oral and Maxillofacial Surgeons of Utah
does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Oral and Maxillofacial Surgeons of Utah:

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)
- Free language services to people whose primary language is not English, such as: Qualified interpreters and Information written in other languages

If you need these services, contact Dave Broadbent.

If you believe that Oral and Maxillofacial Surgeons of Utah
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:

Dave Broadbent, Practice Administrator
2297 N Hill Field Rd Ste A105
Layton, UT 84041
Phone: (801) 779-0506
Fax: (801) 779-4344
Email: Dave@omsofutah.com

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Dave Broadbent, Practice 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, DC 20201

Toll Free: 1-800-368-1019, 800-537-7697 (TDD).

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

A copy of our notice to take reasonable steps to provide alternate language services can be downloaded below. This information is also available in the images shown below.

Alternate language service information.