Disclosures



Notice of Nondiscrimination - ACA Section 1557

Discrimination is Against the Law

[Name of covered entity] complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. [Name of covered entity] does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

[Name of covered entity]:

  • 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 [Name of Civil Rights Coordinator]

If you believe that [Name of covered entity] 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: [Name and Title of Civil Rights Coordinator], [Mailing Address], [Telephone number ], [TTY number—if covered entity has one], [Fax], [Email]. 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, 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.


Statement of Nondiscrimination - ACA Section 1557

[Name of covered entity] complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.


COVID-19



We hope you and your family are in good health. As of May 14, 2020, our dentists are now permitted to return to full provision of services. Our community has been through a lot over the last few months, and we are all looking forward to resuming our normal habits and routines.
While many things have changed, one thing has remained the same: our commitment to your safety. We have taken measures to protect both our patients and our staff and have all the appropriate PPE to treat our patients safely. Infection control has always been a top priority for our practice so we can ensure that when you receive dental care in our office, it's both comfortable and safe. You may see some changes when it is time for your next appointment. We made these changes to help protect our patients and staff. For example:


• Our office will communicate with you beforehand to ask some screening questions. You’ll be asked those same questions again when you are in the office.
• We have hand sanitizer that we will ask you to use when you enter our office. You will also find some in the reception area and other places in our office for you to use as needed.
• You may see that our waiting room will no longer offer magazines, children’s toys and so forth, since those items are difficult to clean and disinfect.
• Appointments will be managed to allow for social distancing between patients and also reduce the number of patients in our reception area at any one time.

We look forward to seeing you again and are happy to answer any questions you may have about the steps we have taken to keep all of our patients safe in our practice. To make an appointment, please call our office at 780-449-5467. If you are unable to reach us, please leave us a message and we will get back to you as soon as we are able. If you have an emergency outside of our business hours, please contact Dr. Hai Nguyen at 780-722-8794.


Thank you for being our patient. We value your trust and loyalty and look forward to seeing you.

Sincerely,
Smile Dental


If you have any questions or concerns, please contact us immediately.   The below links provide additional information regarding the coronavirus:

  

Sincerely,

Smile Dental