Download a copy of our Nondiscrimination Statement [PDF]

Vision Source Meigs Clinic Nondiscrimination Statement

Vision Source Meigs Clinic understands that discrimination is against the law and complies with all applicable Federal and State civil rights laws. Specifically, we do not discriminate on the basis of race, color, national origin, age, disability or sex. We do not exclude patients or treat them any differently based on any of these factors.

When necessary and free of charge to the patient, Vision Source Meigs Clinic:

• Provides aids and services to patients with disabilities when necessary to effectively communicate with them
• Provides qualified sign language interpreters for hearing impaired patients
• Provides language services to those patients who cannot effectively communicate in English. This may include qualified interpreters or written information.

If you believe Vision Source Meigs Clinic has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability or sex, you may file a grievance with:

Karena Roberts,  Grievance Coordinator

Robyn A Pape, OD LLC dba
Vision Source Meigs Clinic

443 General Hartinger Parkway

Middleport, OH 45760

Phone: 740-691-5008

Fax: 740-691-5009

kroberts.meigsclinic@gmail.com

You may file your grievance in person, by mail, fax or email. If you need assistance filing a grievance, Karena Roberts is available to assist you.

You may also file a civil rights complaint with the US Department of Health and Human Services, Office for Civil Rights two ways:

(1) Electronically through the Office of Civil Rights Complaint Portal:

https://ocrportal.hhs.gov/ocr/portal/lobby.jsf

(2) By mail or phone at:

US Department of Health and Human Services

200 Independence Avenue SW Room 509F, HHH Building

Washington, DC 20201

1-800-368-1019 1-800-537-7697 (TDD)

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