Notice of Nondiscrimination

Emerald Psych, LLC complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Emerald Psych, LLC does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Provision of Services

Emerald Psych, LLC:

• Provides free aids and services to people with disabilities to communicate effectively with us, such as qualified sign language interpreters.
• 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, please contact our Civil Rights Coordinator.

How to File a Grievance

If you believe that Emerald Psych, LLC 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:

• Civil Rights Coordinator: Helder Mendes, PMHNP-BC
• Email: hmendes@emeraldpsych.net

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Helder Mendes 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)

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.