Azalea Family Dentistry a Division of Atlantic Dental Care, PLC
Phone: (757) 587-4433
1557 Notice Informing Individuals about Nondiscrimination and Accessibility
Atlantic Dental Care, PLC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Atlantic Dental Care, PLC does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
The Atlantic Dental Care, PLC:
· 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 our Civil Rights Coordinator identify below. If you believe that Atlantic Dental Care, PLC 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 our Civil Rights Coordinator:
Civil Rights Coordinator: Carmen A. Cote, DDS Phone: (757)587-4433 Fax: (757)587-1046
Address: 7913 Azalea Garden Rd, Norfolk VA 23518 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, our Civil Rights Coordinator identified above 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, 1-800-868-1019, 800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
Español (Spanish) ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (757) 587-4433
For other Languages please contact us and we will make translation arrangements.