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Download a copy of our Non-Discrimination Statement [PDF]

Niles Vision Clinic, P.C. Nondiscrimination Statement

Niles Vision Clinic, P.C. 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, Niles Vision Clinic, P.C.:

  • 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 Niles Vision Clinic, 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 may file a grievance with:

Char Marquardt-Grievance Officer

9 South Saint Joseph Ave.

Niles, MI. 49120

Phone: 269-683-4040

Fax: 269-683-7565

Email: char@nilesvisionclinic.com

You may file your grievance in person, by mail, fax or email. If you need assistance filing a grievance, Char Marquardt 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

Niles Vision Clinic, P.C.

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.

Spanish

Arabic

Chinese

Syriac

Vietnamese

Albanian

Korean

Bengali

Polish

German

Italian

Japanese

Russian

Serbo-Croatian

Tagalog