These forms, Notice of Privacy Practices and HIPAA statement, present the information that federal law requires us to give our patients regarding our privacy practices.
This notice is a pdf document which requires the Adobe Reader software. You most likely already have this software on your computer. However, if you have difficulty reading the notice, please click here to install Acrobat Reader.
Discrimination is Against the Law
Oral & Maxillofacial Surgery Associates complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
Oral & Maxillofacial Surgery Associates does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Oral & Maxillofacial Surgery Associates 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), 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 contact Michelle Thoms.
If you believe that Oral & Maxillofacial Surgery Associates 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 the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Compliant 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 Ave., SW, Room 509F, HHH Building, Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)
complaint forms available at https://www.hhs.gov/ocr/office/fil/index.html.