Clarksville Dental Care

529 E. Lewis & Clark Parkway

Clarksville, IN 47129
     (812)725-9200

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OCR NOTICE OF NONDISCRIMINATION

Source: HHS Office for Civil Rights

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

The Smile Spot does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Clarksville Dental Care:

• 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) •

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 our office

If you believe that Clarksville Dental Care 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:

Clarksville Dental Care

529 E. Lewis & Clark Pkwy

P: 812-725-9200

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance,

Our office staff 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- 868-1019, 800-537- 7697 (TDD).

Complaint forms are available at:

http://www.hhs.gov/ocr/office/file/index.html.