Non-Discrimination Notice

Discrimination is against the law. Heritage Sierra Medical Group follows State and Federal civil rights laws. Heritage Sierra Medical Group does not unlawfully discriminate, exclude people, or treat them differently because of sex, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, or sexual orientation.

Heritage Sierra Medical Group provides:

  • Free aids and services to people with disabilities to help them communicate better, such as:

    • Qualified sign language interpreters

    • Written information in other formats (large print, audio, accessible electronic formats, other formats)

  • 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 Heritage Sierra Medical Group from 8:00 a.m. to 5:00 p.m., Monday thru Friday by calling (855) 625-7894. If you cannot hear or speak well, please call TDD/TTY: (800) 806-4474. Upon request, this document can be made available to you in braille, large print, audiocassette, or electronic form. To obtain a copy in one of these alternative formats, please call or write to:

Attn: Corporate Compliance Officer
Heritage Provider Network
8510 Balboa Blvd, Ste 285
Northridge, CA 91325

How To File a Grievance

If you believe that Heritage Sierra Medical Group has failed to provide these services or unlawfully discriminated in another way on the basis of sex, race, color, religion, ancestry, national origin, ethnic group identification, age, mental disability, physical disability, medical condition, genetic information, marital status, gender, gender identity, or sexual orientation, you can file a grievance with Heritage Sierra Medical Group's Compliance Officer. You can file a grievance by phone, in writing, in person, or electronically:

  • By phone: Contact Heritage Sierra Medical Group's Compliance Officer from 8:00 a.m. to 5:00 p.m., Monday thru Friday by calling (855) 625-7894. Or, if you cannot hear or speak well, please call TDD/TTY: (800) 806-4474.

  • In writing: Fill out a complaint form or write a letter and send it to:

Attn: Corporate Compliance Officer
Heritage Provider Network
8510 Balboa Blvd, Ste 285
Northridge, CA 91325

  • In person: Visit your doctor's office or Heritage Sierra Medical Group and say you want to file a grievance.

  • Electronically: Visit Heritage Sierra Medical Group's website at www.heritagesmg.com.

Office of Civil Rights – California Department of Health Care Services

You can also file a civil rights complaint with the California Department of Health Care Services, Office of Civil Rights by phone, in writing, or electronically:

  • By phone: Call (916) 440-7370. If you cannot speak or hear well, please call 711 (Telecommunications Relay Service).

  • In writing: Fill out a complaint form or send a letter to:

Deputy Director, Office of Civil Rights
Department of Health Care Services
Office of Civil Rights
P.O. Box 997413, MS 0009
Sacramento, CA 95899-7413

Complaint forms are available at http://www.dhcs.ca.gov/Pages/Language_Access.aspx.

Office Of Civil Rights - U.S. Department of Health and Human Services

If you believe you have been discriminated against on the basis of race, color, national origin, age, disability or sex, you can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights by phone, in writing, or electronically:

  • By phone: Call 1-800-368-1019. If you cannot speak or hear well, please call TTY/TDD 1-800-537-7697.

  • In writing: Fill out a complaint form or send a letter
     

    U.S. Department of Health and Human Services
    200 Independence Avenue, SW
    Room 509F, HHH Building
    Washington, D.C. 20201

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