NOTICE OF NONDISCRIMINATION
Village Family Dental complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Village Family Dental does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Village Family Dental:
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:
-Information written in other languages
If you need these services, contact the Office Manager of this location.
If you believe that Village Family Dental 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: Alisa Baxley, Civil Rights Coordinator, by mail or phone at:
2028 Litho Place Fayetteville, NC 28304
(910) 485-7070 ext.: 2622
Fax: (910) 485-1151
If you need help filing a grievance, Alisa Baxley, 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/portal/lobby.isf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SE., Room 509F, HHH Building, Washington, DC 20201, 1-800-868-1019, 800-537-7697 (TDD).
Complaint forms are available at: http://www.hhs.gov/ocr/filing-with-ocr/index.html