The Grove Family Dental and TMJ Clinic, LLC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, religion, sex, sexual orientation, gender identity, or marital status. The Grove Family Dental and TMJ Clinic, LLC does not exclude people or treat them differently because of race, color, national origin, age, disability, religion, sex, sexual orientation, gender identity, or marital status.

The Grove Family Dental and TMJ Clinic, LLC provides free aids and services to people with disabilities to communicate effectively with us, such as:  qualified sign language interpreters and 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 and information written in other languages. If you need these services, contact our Office Civil Rights Coordinator.

If you believe that The Grove Family Dental and TMJ Clinic, LLC has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, religion, sex, sexual orientation, gender identity or marital status, you can file a grievance with:

Peter Gernetzke, Office Civil Rights Coordinator

109 S Madison St.

Evansville, WI  53536

TEL: 608.882.4441

FAX: 608.882.4967

smilesbydrjohn@gmail.com

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Peter Gernetzke, Office Civil Rights Coordinator, 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/portal/lobby.jsf, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW. Room 509F, HHH Building Washington, DC 20201 Toll Free: 1-800-868-1019, 800-537-7697 (TDD). Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.