Fourth Street Clinic does not discriminate on the basis of race, ethnicity, color, religion, national origin, sex, pregnancy, pregnancy-related conditions, age, disability, sexual orientation, gender identity, gender expression, genetic information or protected veteran’s status, in employment, treatment, admission, or access to health care and other integrated services. Additionally, Fourth Street Clinic endeavors to provide reasonable accommodations and ensure equal access to qualified persons with disabilities. Click here to request a reasonable accommodation.

NOTICE OF INTERNAL FILING OPTIONS
Where discrimination is found to have occurred, Fourth Street Clinic will take reasonable steps to investigate the matter, stop the harassment, prevent its recurrence and remedy its effects. If you or someone you know has experienced discrimination, sexual misconduct including sexual harassment, or disability discrimination, we encourage you to report it to:

Kassie Shipe
Clinic Services Director
409 West 400 South
Salt Lake City, UT, 84101
kshipe@fourthstreetclinic.org
Patient Complaint Form: Click Here

EXTERNAL FILINGS & AGENCIES
Filing a complaint with Fourth Street Clinic does not prevent an individual from filing a complaint with an appropriate regulatory agency. To file a complaint regarding discrimination, including sexual harassment, or retaliation with a regulatory state or federal agency, please see the agency information below. For information about the time frames in which complaints must be filed, please contact the relevant agency.

Health Care, Human Services, and Health Insurance Plans (Patients and Participants):
Complaints regarding: Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, as amended, the Age Discrimination Act of 1975, Title II of the Americans with Disabilities Act (ADA), and the Community Service Assurance provisions of the Hill-Burton Act

U.S. Department of Health & Human Services
Office for Civil Rights, DHHS – Region VIII
1961 Stout Street Room 08-148
Denver, CO 80294
Customer Response Center: 1-800-368-1019
TDD: 1-800-537-7697
Email: Ocrmail@hhs.gov
Online Complaint Portal: https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf
Website: https://www.hhs.gov/ocr/index.html

Employment:
State Agencies: Individual complaints regarding: Utah Anti-Discrimination Act of 1965, Title VII of the Civil Rights Act of 1964, as amended, Age Discrimination in Employment Act of 1967, as amended, and the Americans with Disabilities Act of 1990.

Utah Anti-Discrimination and Labor Division (UALD)
160 East 300 South, 3rd floor
P.O. Box 146630
Salt Lake City, Utah 84114-6630
Telephone: 801-530-6801
Website: www.laborcommission.utah.gov

Veteran’s Employment and Training Service
140 East 300 South, Room 209
Salt Lake City, UT 84111
Telephone: 801-526-0950
Website: https://jobs.utah.gov/veteran/index.html
Online Complaint Portal: https://www.hud.gov/topics/housing_discrimination

Federal Agencies: Complaints regarding: Title VII of the Civil Rights Act of 1964, The Pregnancy Discrimination Act, Age Discrimination in Employment Act of 1967, as amended (ADEA), Equal Pay Act of 1963, Title I of the Americans with Disabilities Act Amendments Act of 2008, Sections 501 and 505 of the Rehabilitation Act of 1973 and Section 102 and 103 of the Civil Rights Act of 1991, the Genetic Information Nondiscrimination Act of 2008 (GINA)

Equal Employment Opportunity Commission
Phoenix District Office
3300 North Central Avenue, Suite 690
Phoenix, AZ 85012
Telephone: 1-800-669-4000
TTY: 1-800-669-6820
Fax: 602-640-5071
Website: www.eeoc.gov

U.S. Department of Labor
Office of Federal Contract Compliance Programs (OFCCP)
Denver District Office
1244 Speer Blvd, Suite 540
Denver, CO 80204
Phone: 720-264-3200
Fax: 720-264-3211
Website: https://www.dol.gov/agencies/ofccp

Executive Order 11246 (Equal Employment and Affirmative Action)
Americans with Disability Act Amendments Act, of 2008
Section 503 of the Rehabilitation Act of 1973
38 USC 4212 – The Vietnam Era Veterans’ Readjustment Assistance Act of 1974
Uniformed Service Employment and Re-employment Rights Act (USERRA)
Online Complaint Portal: https://webapps.dol.gov/elaws/VeteransIssues.html