Section 1557 of the Affordable Care Act

Notice Informing Individuals About Nondiscrimination and Accessibility Requirements and Nondiscrimination Statement: Discrimination is Against the Law

Matthew J. Severin, D.D.S. complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.  Matthew J. Severin, D.D.S. does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Matthew J. Severin, D.D.S.:

• 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 language

If you believe that Matthew J. Severin, D.D.S. 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: 

Matthew J. Severin, DDS  
5826 S. 147th Street 
Omaha, NE 68137 
United States 

Phone: (402) 895-4555 
Email  office@matthewseverindds.com

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance our office 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 1-402-895-4555 .

CHÚ Ý:  Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn.  Gọi số 1-402-895-4555 .

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 1-402-895-4555

ملاحظة: إذا كنت تتحدث ذكر اللغة، تتوفر لك خدمات المساعدة اللغوية مجانا. دعوة 1-402-895-4555

1-402-895-4555 .

ATTENTION :  Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement.  Appelez le 1-402-895-4555

XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama.  Bilbilaa 1-402-895-4555 .

ACHTUNG:  Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung.  Rufnummer: 1-402-895-4555 .

주의:  한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다.  1-402-895-4555 번으로 전화해 주십시오.

ध्यान दिनुहोस्: तपार्इंले नेपाली बोल्नुहुन्छ भने तपार्इंको निम्ति भाषा सहायता सेवाहरू निःशुल्क रूपमा उपलब्ध छ । फोन गर्नुहोस् 1-402-895-4555

ВНИМАНИЕ:  Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода.  Звоните 1-402-895-4555

ໂປດຊາບ: ຖ້າວ່າ ທ່ານເວົ້າພາສາ ລາວ, ການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາ, ໂດຍບໍ່ເສັຽຄ່າ, ແມ່ນມີພ້ອມໃຫ້ທ່ານ. ໂທຣ 1-402-895-4555 .
 

توجه: اگر شما به زبان فارسی صحبت می کنید، امکانات زبان رایگان خواهد شد را برای شما 1-402-895-4555 تماس ارائه
 

توجه: اگر به زبان فارسی گفتگو می کنید، تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با 1-402-895-4555  تماس بگیرید.
 

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。1-402-895-4555 まで、お電話にてご連絡ください。