Discrimination is Against the Law

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

[Name of covered entity]:

• 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 [Name of Civil Rights Coordinator]

If you believe that [Name of covered entity] 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: [Name and Title of Civil Rights Coordinator], [Mailing Address], [Telephone number ], [TTY number—if covered entity has one], [Fax], [Email]. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, [Name and Title of 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.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.

[Name of covered entity] complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

At Care Family Dental, your health and the health of our staff are of utmost importance.  To ensure this, we follow universal precautions in our operatories and office, including wiping down the waiting room and common areas with medical grade disinfectants.

Due the recent outbreak of Covid-19 virus, we are requesting all our patients to do the following:

• If you have an illness or are exhibiting symptoms, we recommend you cancel and reschedule your dental appointment. Some illness and/or symptoms include:
  • cold, cough or the flu
  • fever or nausea
  • severe headaches or body aches
  • muscle or stomach pain, chest pain or difficulty breathing
  • vomiting or diarrhea
  • active tuberculosis (TB)
  • mumps, measles, chickenpox
  • other contagious disease
• Please notify our staff before your appointment if you or someone you are in close contact with have recently traveled out of the country or if you have been exposed to someone else who was diagnosed with COVID-19 or who was quarantined as a precaution.

If you have any questions or concerns, please contact us immediately.   The below links provide additional information regarding coronavirus:

• World Health Organization (WHO): https://www.who.int
• Centers for Disease Control (CDC): https://www.cdc.gov

We will continue to monitor the situation and provide updated information when warranted.  Thank you for your patronage. Stay Safe and Be Well.