Notice of Nondiscrimination

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

Townesquare Dental:
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 Kristy Mickelsen
If you believe that Townesquare Dental 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: Kristy Mickelsen,
        
527 Rigby Lake Dr Ste B
Rigby, ID 83442-5117
Telephone Number: 208-745-8704, TTY: 800-377-3529, Fax: 208-745-7052, Email: [email protected] You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Kristy Mickelsen 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.

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-800-377-1363 (TTY: 1-800-377-3529).

注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-800-377-1363 （TTY：1-800-377-3529）。

OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su vam besplatno. Nazovite 1-800-377-1363 (TTY- Telefon za osobe sa oštećenim govorom ili sluhom: 1-800-377-1363).

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-800-377-1363 (TTY: 1-800-377-3529)번으로 전화해 주십시오

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ há»— trợ ngôn ngữ miá»…n phí dành cho bạn. Gọi số 1-800-377-1363 (TTY: 1-800-377-3529).

ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم 1-1363-377-800) رقم .(800-377-1363-1 :والبكم الصم ھ

ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-800-377-1363 (TTY: 1-800-377-3529).

PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-800-377-1363 (TTY: 1-800-377-3529).

ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-800-377-1363 (телетайп: 1-800-377-1363).

ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-800-377-1363 (ATS : 1-800-377-3529).

注意事項：日本語を話される場合、無料の言語支援をご利用いただけます。1-800-377-1363（TTY:1-800-377-1363）まで、お電話にてご連絡ください。

ATENÈšIE: Dacă vorbiÈ›i limba română, vă stau la dispoziÈ›ie servicii de asistență lingvistică, gratuit. SunaÈ›i la 1-800-377-1363 (TTY: 1-800-377-3529).

MAANDO: To a waawi [Adamawa], e woodi ballooji-ma to ekkitaaki wolde caahu. Noddu 1-800-377-1363 (TTY: 1-800-377-3529)

s توجھ: اگر بھ زبان فارسی گفتگو Ù…ÛŒ کنید، تسھیلات زبانی بصورت رایگان برای شما .بگیرید تماس         1-800-377-1363 (TTY: 1-800-377-3529) با. باشد Ù…ÛŒ ف

УВАГА! Якщо ви розмовляєте українською мовою, ви можете звернутися до безкоштовної служби мовної підтримки. Телефонуйте за номером 1-800-377-1363 (телетайп: 1-800-377-1363).