Zeeland 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.
Zeeland Family Dentistry does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Zeeland Family Dentistry:
- Provides free aid 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 is written in other languages
If you need these services, contact the office manager.
If you believe that Zeeland 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:
Zeeland Family Dentistry
25 N State St
Zeeland, MI 49464
Phone (616) 772-2868
Fax (616) 772-4805
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Becky Pollack 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, 1-800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html