Kids By the Bay Dental

Kids By THe Bay Dental logo

301-640-5437

FORMS

NOTICE OF NON-DISCLOSURE

NOTICE OF NON-DISCLOSURE

Kids By The Bay Dental complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Kids By The Bay Dental does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Kids By The Bay Dental :

  • 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, 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, contact  301-640-5437.

If you believe that Kids By The Bay Dental  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: 

 Kids By The Bay Dental
5010 Regency Place Suite 102
White Plains, MD 20695
Phone: 301-640-5437
Email: info@kidsbythebaydental.com

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Kids By The Bay Dental 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, D.C. 20201
1-800-368-1019 ,800-537-7697 (TDD)