Island Children's Dentistry

Before coming to your your appointment, please complete the COVID-19 Informed Consent Form
Before coming to your your appointment, please complete the COVID-19 Informed Consent Form

 

Island Children’s Dentistry & Orthodontics complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Island Children’s Dentistry & Orthodontics does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Island Children’s Dentistry & Orthodontics:

  • 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 (703) 790-1320.

If you believe that Island Children’s Dentistry & Orthodontics 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: 

Island Pediatric Dentistry
1500 Cornerside Blvd #310
Tysons Corner, VA 22182
Phone: (703) 790-1320
Email: smiles@islandchildrensdentistry.com

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Island Children’s Dentistry & Orthodontics 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)