Dermatology Consultants, Inc. complies with applicable Federal civil right laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Dermatology Consultants, Inc. does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Dermatology Consultants, Inc.

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)

• Provides 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 our Practice Manager, Kelly Kraft-Meyer.

If you believe that Dermatology Consultants 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: Kelly Kraft-Meyer, Practice Manager, 1330 Oak Lane, Lynchburg, VA 24503, (434) 847-6132, TTY 1-800-828-1140, fax: (434) 845-4870, info@lynchburgdermatology.com. You can file a grievance in person or by mail, fax or email. If you need help filing a grievance, Kelly Kraft-Meyer, Practice Manager, 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.

Alternative Language Options for Notices and Other Written Information

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-434-592-3768 (TTY: 1-800-828-1140).

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-434-592-3768 (TTY: 1-800-828-1140)번으로 전화해 주십시오.

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-434-592-3768 (TTY: 1-800-828-1140).

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 1-434-592-3768（TTY：1- 800-828-1140）

ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم 1-xxxx-xxx-xxx) رقم

.(0411-828-008-1 :والبكم الصم ھ

PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-434-592-3768 (TTY: 1-800-828-1140).

توجھ: اگر بھ زبان فارسی گفتگو می کنید، تسھیلات زبانی بصورت رایگان برای شما

.بگیرید تماس 1-434-592-3768 (TTY: 1-800-828-1140) با. باشد می ف

ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች፣ በነጻ ሊያግዝዎት ተዘጋጀተዋል፡ ወደ ሚከተለው ቁጥር ይደውሉ 1-xxx-xxx-xxxx (መስማት ለተሳናቸው: 1-xxx-xxx-xxxx).

خبردار: اگر آپ اردو بولتے ہیں، تو آپ کو زبان کی مدد کی خدمات مفت میں دستیاب ہیں ۔ کال 1-xxx-xxx-xxxx (TTY: 1-800-828-1140). ک

ATTENTION : Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 1-434-592-3768 (ATS : 1-800-828-1140).

ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-434-592-3768 (телетайп: 1-800-828-1140).

ध्यान द�: य�द आप �हदी बोलते ह � तो आपके िलए मुफ्त म� भाषा सहायता सेवाएं उपलब्ध ह।� 1-434-592-3768 (TTY: 1-800-828-1140) पर कॉल कर�।

ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-434-592-3768 (TTY: 1-800-828-1140).

ল�য্ কর‍নঃ যিদ আপিন বাংলা, কথা বলেত পােরন, তাহেল িনঃখরচায় ভাষা সহায়তা পিরেষবা উপল� আেছ। েফান কর‍ন ১-xxx-xxx-xxxx (TTY: 1-800-828-1140)।

Dè ɖɛ nìà kɛ dyéɖé gbo: Ɔ jǔ ké m̀ [Ɓàsɔ́ ɔ̀ -wùɖù-po-nyɔ̀ ] jǔ ní, nìí, à wuɖu kà kò ɖò po-poɔ̀ ɓɛ́ ìn m̀ gbo kpáa. Ɖá 1-434-592-3768 (TTY:1-800-828-1140)