NONDISCRIMINATION NOTICE AND LANGUAGE ASSISTANCE SERVICES

Independence Park Medical Services (IPMS) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. IPMS does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Independence Park Medical Services:

If you believe that IPMS 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 Clinic Administrator in person or by mail, fax, or email. If you need help filing a grievance, our Clinic Administrator 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, 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
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