Advanced Dermatology of the Midlands
Notice of Non-Discrimination
Advanced Dermatology of the Midlands, PC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Advanced Dermatology of the Midlands, PC does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Advanced Dermatology of the Midlands, PC:
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 Charles Farley. If you believe that Advanced Dermatology of the Midlands, PC 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: Charles Farley, Practice Manager, 12910 Pierce Street, Omaha, NE 68144, 402-933-3770, Fax: 402-916-4662, Email: Charles.firstname.lastname@example.org. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Charles Farley, Practice Manager 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, 1–800–368–1019, 800–537–7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.