Eye Care of John Day Nondiscrimination Statement

Eye Care of John Day understands that discrimination is against the law and complies with all applicable Federal and State civil rights laws. Specifically, we do not discriminate on the basis of race, color, national origin, age, disability or sex. We do not exclude patients or treat them any differently based on any of these factors.

When necessary and free of charge to the patient, Eye Care of John Day:
Provides aids and services to patients with disabilities when necessary to effectively communicate with them
Provides qualified sign language interpreters for hearing impaired patients
Provides language services to those patients who cannot effectively communicate in English. This may include qualified interpreters or written information.

If you believe Eye Care of John Day has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability or sex, you may file a grievance with:

David M. Archibald, OD
401 W Main Street Ste. A
John Day, OR 97845
P# 541-575-1819
F# 855-420-9603
johndayeyecare@yahoo.com

You may file your grievance in person, by mail, fax or email. If you need assistance filing a grievance, Eye Care of John Day office staff are available to assist you.

You may also file a civil rights complaint with the US Department of Health and Human Services, Office for Civil Rights two ways:
1. Electronically through the Office of Civil Rights Complaint portal:
https://ocrportal.hhs.gov/ocr/portal/lobby/jsf

2. By mail or phone at:

Us department of Health and Human Services
200 Independence Avenue SW Room 509F, HHH Building
Washington, DC 20201

P# 1-800-368-1019 1-800-537-7697 (TDD)

Complaint forms are available at:
http://www.hhs.gov/ocr/office/file/index.html