Williamsburg Urgent Care complies with applicable Federal civil rights laws and does not

discriminate on the basis of race, color, national origin, age, disability, or sex. Williamsburg Urgent Care

does not exclude people or treat them differently because of race, color, national origin,

age, disability, or sex.

Williamsburg Urgent Care:

•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, please inform a staff member.

If you believe that Williamsburg Urgent Care 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:

Administrative Services

Williamsburg Urgent Care

5239 Monticello Ave, Suites B,C

Williamsburg, VA 23188

admin@WilliamsburgUC.com

Fax: (757) 279-8189

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

Administrative Services 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)

Such complaints must be filed within one hundred eighty (180) days of the date of the alleged

discrimination.