Discrimination is Not Tolerated in This Medical Practice (WTMF)
Washington Township Medical Foundation
In accordance with the ethical standards of the medical profession, Washington
Township Medical Foundation complies with applicable Federal civil rights
laws and does not discriminate on the basis of race, color, national origin,
age, disability, or sex. Our practice also does not exclude people or
treat them differently due to race, color, national origin, age, disability,
or sex. We provide the following:
-
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)
-
Free language services to people whose primary language is not English, such as:
- Qualified interpreters
- Information written in other languages
If you need these services, please inform our practice: Christian Rieta,
Director of Quality and Compliance: 2500 Mowry Ave, Suite 255, Fremont,
CA 94538. Phone 510-248-1056, fax 510-608-6055, or e-mail at
Christian_Rieta@mywtmf.com.
If you believe that Washington Township Medical Foundation 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:
Christian Rieta, Director of Quality and Compliance
2500 Mowry Ave., Suite 255, Fremont, CA 94538
(P) 510-248-1056, (F) 510-608-6055
Christian_Rieta@mywtmf.com.
You can file a grievance in person or by mail, fax, or email. If you need
help filing a grievance, Christian Rieta 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. 20201
(800) 368-1019, or 800-537-7697 (TDD)
Complaint forms are available at
http://www.hhs.gov/ocr/office/file/index.html
For additional languages, click
here.