NOTICE OF NON-DISCRIMINATION

NOTICE OF NON-DISCRIMINATION

Nebraska Spine and Pain Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. [Name of covered entity] does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Nebraska Spine and Pain Center:

  • 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, please contact our Civil Rights Coordinator.

Sue Carlson RN
Nebraska Spine and Pain Center
13616 California Street, Suite 100
Omaha NE  68154
Telephone:  (402) 496-0404
Fax:  (402) 496-7766

If you believe that Nebraska Spine and Pain Center 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 our Civil Rights Coordinator, Sue Carlson RN.  You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Sue Carlson RN 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.

INTERPRETATION SERVICES NOTIFICATION

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