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MCHD Dentistry
453 Van Voorhis Road
Morgantown, WV 26505
304-598-5108 Phone
304-598-5110 Fax
www.mchddentistry.com
NOTICE OF NONDISCRIMINATION
MCHD Dentistry complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. MCHD Dentistry does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
MCHD Dentistry:
• 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, please contact Dr. Lee Smith.
If you believe that MCHD Dentistry 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:
Dr. Lee Smith
453 Van Voorhis Road
Morgantown, WV 26505
Phone 304-598-5100
Fax 304-598-5599
or by email at lee.b.smith@wv.gov
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Dr. Lee Smith 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
1-800-868-1019, 800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
MCHD Dentistry complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. MCHD Dentistry does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
MCHD Dentistry:
• 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, please contact Dr. Lee Smith.
If you believe that MCHD Dentistry 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:
Dr. Lee Smith
453 Van Voorhis Road
Morgantown, WV 26505
Phone 304-598-5100
Fax 304-598-5599
or by email at lee.b.smith@wv.gov
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Dr. Lee Smith 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
1-800-868-1019, 800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
