NOTICE OF NONDISCRIMINATION

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

Clive Behavioral Health:

• 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, contact Brittani Corbin, Patient Advocate.
If you believe that Clive Behavioral Health 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:

Carrie Smith, Patient Advocate
Clive Behavioral Hospital
1450 NW 114th Street Clive, Iowa 50325
Phone: 515-553-6200
Fax: 515-461-2234
Email: [email protected]

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Brittani Corbin, Patient Advocate is available to help you.

You can also file a civil rights complaint with U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at ocrportal.hhs.gov, or by mail or phone at:

U.S. Dept. 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 www.hhs.gov.