Notice of Nondiscrimination

Nondiscrimination Statement

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

Accessibility & Accommodations

Rockdale Family Dentistry provides:

• Free aids and services to people with disabilities to communicate effectively with us, such as qualified sign language interpreters and 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 qualified interpreters and information written in other languages.

If you need these services, please contact our front desk at (770) 922-7831.

How to File a Grievance

If you believe that Rockdale Family 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:

• Rockdale Family Dentistry
  1927 Highway 138 NE, Suite 300, Conyers, GA 30013
  Phone: (770) 922-7831
  Email: rockdalefamilydentistry@gmail.com

You can file a grievance in person, by mail, or by 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, D.C. 20201
Phone: 1-800-368-1019, TDD: 1-800-537-7697

Complaint forms are available at https://www.hhs.gov/ocr/complaints/index.html.