Texas Ear, Nose and Throat Specialists (“the Practice”) does not exclude, deny benefits to, or otherwise discriminate against any person on the ground of race, color, national origin, age, disability (physical or mental) or sex in admission to, participation in, or receipt of the services and benefits under any of its programs and activities, and in staff and employee assignments to patients. The Practice provides:
If you believe that the Practice 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 firstname.lastname@example.org. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the office manager at the physician’s office is available to help you. You may 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.