Notice Informing Individuals about Nondiscrimination and Accessibility Requirements and Nondiscrimination Statement:
Discrimination is Against the Law Athens Heart Center and Specialty Clinics comply with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Athens Heart Center and Specialty Clinics do not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. Athens Heart Center and Specialty Clinics: • Provide 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) • Provide 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 Greg Wilborn, Compliance Officer Athens Heart Center and Specialty Clinics 2005 Prince Ave. Athens, GA 30606 Phone: 706-208-9700 Fax: 706-208-0806 Email: firstname.lastname@example.org If you believe that Athens Heart Center and Specialty Clinics have 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: Greg Wilborn, Compliance Officer (see contact information above) and/or Emily E. Crabbe, Esq., Civil Rights Investigator Office for Civil Rights U.S. Department of Health and Human Services Sam Nunn Atlanta Federal Center, Suite 16T70 61 Forsyth Street, S.W. Atlanta, GA 30303-8909 Customer Response Center: (800) 368-1019 Email: email@example.com You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Greg Wilborn, Compliance Officer 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.