Notice of Nondiscrimination
Every patient is welcome here. That's not a slogan. It's a legal commitment.
Our policy
East Salem Dental complies with applicable federal civil rights laws, including Section 1557 of the Affordable Care Act, and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity, religion, or source of payment (including Oregon Health Plan membership). We do not exclude people or treat them less favorably for any of these reasons.
Free services we provide
- Language assistance — free of charge, for patients whose primary language is not English, including bilingual staff and qualified interpreters
- Aids and services for people with disabilities — including qualified sign language interpreters and written information in accessible formats, at no cost with advance notice
If you need these services, call (503) 555-0123.
Language assistance taglines
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (503) 555-0123. Nuestro equipo bilingüe le atiende directamente en español todos los días.
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số (503) 555-0123.
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните (503) 555-0123.
注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 (503) 555-0123。
How to file a grievance
If you believe we have failed to provide these services or discriminated in another way, you can file a grievance with our Civil Rights Coordinator: East Salem Dental, Attn: Civil Rights Coordinator, 1251 Lancaster Dr NE, Salem, OR 97301, phone (503) 555-0123, email hello@eastsalemdental.com. You can file in person, by mail, or by email, and we can help you file if you need assistance.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically at ocrportal.hhs.gov, or by mail at 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201, or by phone at 1-800-368-1019 (TDD: 1-800-537-7697).