Notices

OCR NOTICE OF NONDISCRIMINATION
Source: HHS Office for Civil Rights
Northwest OB-GYN complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Northwest OB-GYN does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Northwest OB-GYN:
• 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 Sharlie Siron.  If you believe that Northwest OB-GYN
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:
Sharlie Siron, W 105 Eighth Ave, Ste 6020, Spokane, WA 99204
Telephone number:  509-455-5050; Fax number 509-624-5034; SharlieS@nw-woman.com.
You can file a grievance in person or by mail, fax, or email. If you need help filing a
grievance, [Name and Title of 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.