LOCALLY OWNED
TO SERVE
YOU BETTER.

Discrimination is Against the Law

Makovicka/Harms Group, PC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age disability, or sex. Makovicka/Harms Group,
PC does not exclude people or treat them different because of race, color, national origin, age, disability or sex.

Makovicka/Harms Group, PC:
• 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 and other formats)
• Provides 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 contact the clinic director at your particular location.

If you believe that Makovicka/Harms Group, PC 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: Dan McCutchen, Chief Compliance Officer, PO Box 34669, Omaha, NE 68154-2640, phone number (402) 932-6791, fax (402) 614-7835 or email compliance@makovickapt.com. You can file the grievance in person, by mail, by fax, or by email. If you need help filing a grievance, Dan McCutchen, Chief
Compliance Offices is available to help.

You can also file a civil rights complaint with the US Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Portal, available at:
https://ocrportal.hhs.gov/ocr/portal/lobby.jsf,
or by mail or phone at:
US Department of Health and Human Services
200 Independence Ave, SW
Room 509F
HHH Building
Washington, DC 20201
800-368-1019 or 800-537-7696 (TDD)