OCR NOTICE OF NONDISCRIMINATION

Source: HHS Office for Civil Rights

William P. Buck Jr. D.M.D. P.C.
complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

William P. Buck Jr. D.M.D. P.C.
does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

William P. Buck Jr. D.M.D. P.C.:

  • 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)
    • Free language services to people whose primary language is not English, such as: Qualified interpreters and Information written in other languages

If you need these services, contact Alesia Wright.

If you believe that William P. Buck Jr. D.M.D. P.C.
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:

Alesia Wright, Patient Coordinator
1112 South 19th Street
Birmingham, AL 35205
Phone: (205) 933-1331
Fax: n/a
Email: awright@buckoralsurgery.com

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Alesia Wright, Patient Coordinator 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, DC 20201

Toll Free: 1-800-368-1019, 800-537-7697 (TDD).

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