Discrimination is not tolerated in this medical practice
In accordance with the ethical standards of the medical profession, Bay Area Retina Associates complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Our practice also does not exclude people or treat them differently due to race, color, national origin, age, disability, or sex. We provide the following:
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)
Free language services to people whose primary language is not English, such as:
Information written in other languages
If you need these services, please inform our practice:
Bay Area Retina Associates, Laura O’Flaherty, Civil Rights Coordinator.
122 La Casa Via, Suite 223, Walnut Creek, CA 94598, 925-943-6800, firstname.lastname@example.org.
If you believe that Bay Area Retina Associates 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:
Laura O’Flaherty, Practice Administrator, 122 La Casa Via, Suite 223, Walnut Creek, CA 94598, 925-943-6800, email@example.com. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Laura O’Flaherty, 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/smartscreen/main.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
(800) 368-1019, or 800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html