Nondiscrimination Statement

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

Sunshine Pediatrics:
• Provides free aids and services to people with disabilities to communicate effectively with us, such as qualified sign
language interpreters or 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 or
information written in other languages.

If you need these services, contact Richard Dicks, Jr. 400 W. Robinson Street, #S-936K Orlando, Florida 32801-1782
Phone: 407-317-7552 / Cell: 407-489-2038 / Fax: 407-834-3470

If you believe that Sunshine Pediatrics 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: Richard Dicks, Jr. 400 W. Robinson
Street, #S-936K Orlando, Florida 32801-1782 Phone: 407-317-7552 / Cell: 407-489-2038 / Fax: 407-834-3470

 

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Richard Dicks, Jr. 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.

©2018SunshinePediatrics