OCR NOTICE OF NONDISCRIMINATION

Source: HHS Office for Civil Rights

Harbor Light Oral & Maxillofacial Surgeons, Inc.
complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

Harbor Light Oral & Maxillofacial Surgeons, Inc.
does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Harbor Light Oral & Maxillofacial Surgeons, 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)
    • Free language services to people whose primary language is not English, such as: Qualified interpreters and Information written in other languages

If you need these services, contact Contact the Practice Administrator.

If you believe that Harbor Light Oral & Maxillofacial Surgeons, Inc.
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:

Contact the Practice Administrator,
4646 Nantucket Ste A
Toledo, OH 43623
Phone: (419) 517-2100
Fax: n/a
Email: mhainen@oralmaxsurgeons.com

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Contact the Practice 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, 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: 1-800-368-1019, 800-537-7697 (TDD).

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.