Notice of Nondiscrimination

Alpine Foot & Ankle Clinic complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Alpine Foot & Ankle Clinic does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Alpine Foot & Ankle Clinic 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)

Alpine Foot & Ankle Clinic provides free language services to people whose primary language is not English, such as information written in other languages. If you need these services, contact Alpine Foot & Ankle Clinic’s Compliance Officer.

If you believe that Alpine Foot & Ankle 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 can file a grievance with:

• Alpine Foot & Ankle Clinic’s Compliance Officer: Krista Neibauer
• Mailing Address: 1845 Bancroft St, Missoula, MT 59801
• Telephone number: (406) 721-4007
• Fax: (406) 549-9807
• Email: kneibauer@alpinefoot.com

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Alpine Foot & Ankle Clinic’s Compliance Officer 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.