Notice of Nondiscrimination

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

Steven P. Utecht, DDS:

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 Susan Hancock

If you believe that Steven P. Utecht, DDS 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: Susan Hancock, 441 S Livernois Rd Ste 245 Rochester, MI 48307, Telephone Number: 248-651-7312, TTY: 248-651-7312, Fax: 248-651-9317, Email: [email protected] You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Susan Hancock 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 1-248-651-7312  (TTY: 1-248-651-7312 ).

ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم 1-7312-651-248) رقم .(248-651-7312 -1 :والبكم الصم ھ

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 1-248-651-7312  ï¼ˆTTY：1-248-651-7312 ）。

ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم 1-248-651-7312 ) رقم .(1-248-651-7312  :والبكم الصم Ú¾

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ há»— trợ ngôn ngữ miá»…n phí dành cho bạn. Gọi số 1-248-651-7312  (TTY: 1-248-651-7312 ).

KUJDES: Nëse flitni shqip, për ju ka në dispozicion shërbime të asistencës gjuhësore, pa pagesë. Telefononi në 1-248-651-7312  (TTY: 1-248-651-7312 ).

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-248-651-7312  (TTY: 1-248-651-7312 )번으로 전화해 주십시오

লক্ষ্য করুনঃ যদি আপনি বাংলা, কথা বলতে পারেন, তাহলে নিঃখরচায় ভাষা সহায়তা পরিষেবা উপলব্ধ আছে। ফোন করুন ১-1-248-651-7312  (TTY: ১ 1-248-651-7312 )।

UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpÅ‚atnej pomocy jÄ™zykowej. ZadzwoÅ„ pod numer 1-248-651-7312  (TTY: 1-248-651-7312 ).

ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-248-651-7312  (TTY: 1-248-651-7312 ).

ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1-248-651-7312  (TTY: 1-248-651-7312 ).

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。1-248-651-7312 （TTY:1-248-651-7312 ）まで、お電話にてご連絡ください。

ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-248-651-7312  (телетайп: 1-248-651-7312 ).

OBAVJEŠTENJE: Ako govorite srpsko-hrvatski, usluge jezičke pomoći dostupne su vam besplatno. Nazovite 1-248-651-7312  (TTY- Telefon za osobe sa oštećenim govorom ili sluhom: 1-248-651-7312 ).

PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-248-651-7312  (TTY: 1-248-651-7312 ).