Disclosures

Discrimination is Against the Law

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

Piedmont 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:
  Qualified interpreters
  Information written in other languages

If you need these services, contact Mary Johnson.

If you believe that Piedmont 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: Mary Johnson, 2860 Piedmont Ave., Duluth, MN, 218-722-0823 (phone), 218-722-7635 (fax), or email at administrator@piedmontheightsdental.com. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Mary Johnson 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)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

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

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