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Notice of Nondiscrimination

Appendix A to Part 92—Sample Notice Informing Individuals About Nondiscrimination and Accessibility Requirements and Sample Nondiscrimination Statement:

Discrimination is Against the Law

Ayres Chiropractic & Sports Injury Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. [Name of covered entity] does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Ayres Chiropractic & Sports Injury Center:

  • 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 Dr. Thomas Ayres

If you believe that Ayres Chiropractic & Sports Injury Center 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:

Dr. Thomas Ayres
6837 Falls of Neuse Rd
North Raleigh, NC 27615
P: (919) 846-0100
F: (919) 846-3695

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Dr. Thomas Ayres, Chiropractor 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, 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)

Complaint forms are available at

Have a disability? Speak a language other than English? Call to get help for free.

¿Habla español? ¿Tiene alguna discapacidad? Llame para obtener ayuda de forma gratuita.

Èske w pale kreyòl ayisyen? Èske w andikape? Rele nou pou w jwenn èd gratis.

Quý vị nói tiếng Việt? Quý vị bị khuyết tật? Hãy gọi trợ giúp miễn phí.

Você fala potuguês? Tem alguma deficiência? Telefone para obter assistência.


Vous parlez français ? Vous avez une incapacité ? Appelez pour recevoir une assistance gratuite

Nagsasalita ng Tagalog o Filipino? May kapansanan? Tumawag para sa libreng tulong.

Вы говорите по-русски? Вы являетесь инвалидом? Свяжитесь с нами для получения бесплатной помощи по телефону

ي ؟(ال عرب ية) ت تحدث هل .مجان ية م ساعدة ع ىل ل لح صول ات صل إعاق ة؟ من ت عان

Parli italiano? Hai una disabilità? Chiama per un’assistenza gratuita.

Sprechen Sie deutsch? Haben Sie eine Behinderung? Rufen Sie an, um kostenlos Hilfe zu erhalten.

한국어 통역이 필요하세요? 장애가 있나요? 전화하시면 무료로 도와드립니다.

Mówisz po polsku? Jesteś osobą niepełnosprawną? Zadzwoń po bezpłatną pomoc.

ગુજરાતી બોલો છો? અક્ષમતા ધરાવો છો? મફત સહાયતા મેળવવા ફોન કરો.

พูดภาษาไทยได ้? เป็นผพู้ กิ ารใชห่ รอื ไม? ่ โทรศัพทข์ อรบั ค าปรกึษาไดฟ้ รี


ت ماس رای گان ک مک دری اف ت ب رای ه س ت ید؟ م ع لول یت دارای ک ن ید؟ یم صح بت ف ار یس زب ان ب ه ب گ ریی د