Merivane Private Medicine complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. We do not exclude people or treat them differently because of these characteristics.
We provide free help
- Free aids and services to people with disabilities so they can communicate effectively with us, such as written information in large print or other 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 our office at (512) 555 0187.
Language assistance
Español: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al (512) 555 0187.
How to file a grievance
If you believe we have failed to provide these services or discriminated in another way, you can file a grievance in person, by mail, by phone or by email with our Privacy Officer. If you need help filing a grievance, our team 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, or by mail or phone.
Contact
Merivane Private Medicine
Attn: Privacy Officer
1180 Westlake Hollow Drive, Suite 210
Austin, TX 78746
Phone: (512) 555 0187
Email: care@merivanemedicine.com