Dalton Ear, Nose & Throat Associates, PC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Dalton Ear, Nose & Throat Associates, PC does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Dalton Ear, Nose & Throat Associates, PC 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 formats)

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 us.

If you believe that Dalton Ear, Nose & Throat Associates, PC 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:

1436 Chattanooga Ave
Dalton, GA 30720
Phone: 706-226-2142
Fax: 706-226-1771

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, we are available to help you.

You can 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
• By mail at:

U.S. Department of Health and Human Services
200 Independence Ave. SW
Room 509F HHH Building
Washington, DC 20201

By phone at 1-800-368-1019; 800-537-7697 (TDD)

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

Interpretor Services

Dalton Dalton Ear, Nose & Throat Associates, PC has arranged for language assistance services free of charge. Call (706) 226-2142.