Robert S. Kapust O.D
Nondiscrimination Statement
Robert Kapust Optometry 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, Robert Kapust Optometry:
If you believe Robert Kapust Optometry 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:
Evelyn Lara, Grievance Officer
703 Pier Ave Suite C
Hermosa Beach CA 90254
310.374.9899
310.376.1195
evee.drkapust@gmail.com
You may file your grievance in person, by mail, fax or email. If you need assistance filing a grievance, Evelyn Lara 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:
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
Nondiscrimination Statement
Robert Kapust Optometry 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, Robert Kapust Optometry:
- 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 Robert Kapust Optometry 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:
Evelyn Lara, Grievance Officer
703 Pier Ave Suite C
Hermosa Beach CA 90254
310.374.9899
310.376.1195
evee.drkapust@gmail.com
You may file your grievance in person, by mail, fax or email. If you need assistance filing a grievance, Evelyn Lara 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:
- Electronically through the Office of Civil Rights Complaint Portal: https://ocrportal.hhs.gov/ocr/portal/lobby.jsf
- By mail or phone at:
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
