NOTICE OF NONDISCRIMINATION
Sequatchie Valley Dental Associates, PC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age or sex.
Sequatchie Valley Dental Associates, PC does not exclude people or treat them differently because of race, color, national origin, age, disability, sexual orientation or gender identity.
If you believe that Sequatchie Valley Dental Associates, PC has failed to provide services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:
Kaz D Hasnani, D.M.D., Dental Director
507 Betsy Pack Drive
Jasper, TN 37347
Email: [email protected]
You can file a grievance in person, by fax or by email. If you need help filing a grievance, Kaz Hasnani, DMD 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: 1-800-868-1019, 1-800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html