Kootenai Vision Center Nondiscrimination Statement

Kootenai Vision Center 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, Kootenai Vision Center:
• 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 Kootenai Vision Center 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:

Idaho Commission on Human Rights
317 West Main Street
Boise, ID 83735-0660
Ph: (208) 334-2873
Toll Free: (888) 249-7025
FAX: (208) 334-2664
inquiry@ihrc.idaho.gov

You may file your grievance in person, by mail, fax or email. If you need assistance filing a grievance, {Grievance Officer} is 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
1-800-368-1019 1-800-537-7697 (TDD)

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

Kootenai Vision Center
Individuals With Limited English Proficiency
Information Regarding Language Assistance Services

ATTENTION: If you speak any of the following languages, language assistance services are available (free of charge) to you upon request. (Insert the languages listed on the HHS website per the practice’s individual state)

Spanish
Chinese
Serbo-Croatian
Korean
Nepali
Vietnamese
Arabic
German
Tagalog
Russian
French
Japanese
Romanian
Bantu
Persian (Farsi)