Non-Discrimination Policy

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

Retina Consultants of Michigan, PLC:

· Provides free aids and services to people with disabilities to communicate effectively with us, such as:

o Qualified sign language interpreters

o 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:

o Qualified interpreters

o Information written in other languages (see below).

If you need these services, contact Shirley Harris at 29201 Telegraph Road, Southfield, MI 48034 or by phone at (248) 356-8610.

If you believe that Retina Consultants of Michigan, PLC 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: Kelli Duffy. You can file a grievance in person or by mail, phone or email. If you need help filing a grievance, Kelli Duffy, Practice Administrator at 29201 Telegraph Road, Ste. 606, Southfield, MI 48034 or by phone at (248) 356-3610 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

LANGUAGE ASSISTANCE SERVICES

Posted 10/25/16