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Discrimination is Against the Law:

Capital City Pediatric Dentistry complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Capital City Pediatric Dentistry does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

In order to effectively communicate with all patients, Capital City Pediatric Dentistry:

Provides free aids and services to persons with disabilities, such as:

  • Qualified sign language interpreters

  • Written information in other formats (large print, audio, accessible electronic formats)

Provides free language services to persons whose primary language is not English, such as:

  • Qualified interpreters

  • Information written in other languages

If you need these services, contact Sharon Grey

If you believe that Capital City Pediatric Dentistry 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:

Capital City Pediatric Dentistry
Attn: Sharon Grey
2406 Blue Ridge Road
Suite #210
Raleigh, NC  27607
(919) 782-9560 ext 104
(919) 887-2760 direct line
(919) 782-9560 or (919) 900-7545 Fax
info@capitalcitypediatricdentistry.com

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance,

Sharon Grey with Capital City Pediatric Dentistry 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/smartscreen/main.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. 21201
1 (800) 368-1019; (800) 537-7697 (TDD).

Complaint forms are available at http://www.hhs.gov/ocr/filing-with-ocr/index.html.

Capital City Pediatric Dentistry promises to:

  • Serve all patients

  • Provide free aids and services to all persons covered under this Notice

  • Not deny health services based on:

    • Race

    • Color

    • National origin

    • Age

    • Sex

    • Disability

ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 919-782-9560.

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 919-782-9560 。

CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 919-782-9560.

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 919-782-9560 번으로 전화해 주십시오.

ATTENTION: Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 919-782-9560.

ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغویة تتوافر لك بالمجان. اتصل برقم 919-782-9560رقم .

LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. Hu rau 919-782-9560.

ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 919-782-9560.

PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 919-782-9560

ચુ ના: જો તમેજરાતી બોલતા હો, તો િન:લ્કુ ભાષા સહાય સેવાઓ તમારા માટઉપલબ્ધ છ. ફોન કરો 919-782-9560

្របយ័ត៖ េបើសិនអកនិយ ែខ រ, េសជំនួយែផក េយមិនគិតឈ ល គឺចនសំប់បំេរ អក។ ចូរ ទូរស័ព 919-782-9560

ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 919-782-9560.

ध्यान द: यद आप हदी बोलते ह  तो आपके िलए मुफ्त म भाषा सहायता सेवाएं उपलब्ध ह। 919-782-9560.

ໂປດຊາບ: ຖ້າວ່າ ທ່ານເວົ້າພາສາ ລາວ, ການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາ, ໂດຍບໍ່ເສັຽຄ່າ, ແມ່ນມີພ້ອມໃຫ້ທ່ານ. ໂທຣ 919-782-9560

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。919-782-9560

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