OCR Notice of Nondiscrimination
Source: HHS Office for Civil Rights
Ancheta Pediatric Dental LLC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Ancheta Pediatric Dental LLC does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Ancheta Pediatric Dental LLC
• 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 Janel Ancheta-Carroll, DMD
If you believe that Ancheta Pediatric Dental LLC 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: Janel Ancheta-Carroll, DMD 98-1247 Kaahumanu St. #205, [ Telephone number 808-487-1000 ] [ Fax: 808-487-1004 ][ Email: firstname.lastname@example.org ]
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Janel Ancheta-Carroll, DMD 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.