Notice of Non-Discrimination

Buda Pediatric Dentistry complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Buda Pediatric Dentistry does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

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Buda Pediatric Dentistry:

• 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

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If you need these services, contact Buda Pediatric Dentistry.

If you believe that Buda Pediatric 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:

Buda Pediatric Dentistry

Phone: (512) 710-7570

Email: hello@budapediatricdentistry.com

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You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Buda Pediatric Dentistry 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)

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