Notice of Nondiscrimination 

Discrimination Is Against the Law. 

Excelsior Orthopaedics, LLP complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex (consistent with the scope of sex discrimination described at 45 CFR § 92.101(a)(2)). 

Excelsior Orthopaedics, LLP does not exclude people or treat them less favorably because of race, color, national origin, age, disability, or sex. 

Accessibility and Language Assistance Services 

Excelsior Orthopaedics, LLP provides the following services: 

1.Assistancefor Individuals with Disabilities 

• Reasonable modifications 

• Free, appropriate auxiliary aids and services to communicate effectively, including: 

• Qualified sign language interpreters 

• Written information in other formats (large print, audio, accessible electronic formats, or other formats)

2. Language Assistance Services

• Free language assistance services for individuals whose primary language is not English, which may include: 

• Qualified interpreters 

• Information written in other languages 

How to Request Assistance 

If you need reasonable modifications, appropriate auxiliary aids and services, or language assistance services, please contact: 

Section 1557 Coordinator: Pam Larkin 

 Email: [email protected]  

Phone: 716-250-6402 Fax: 716-250-6555 

Excelsior Orthopaedics, 3921 Sheridan Drive, Amherst, NY 14226 

Filing a Grievance 

If you believe that Excelsior Orthopaedics, LLP has failed to provide these services or has discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you may file a grievance with Civil Rights Coordinator: 

Pam Larkin , Director Revenue Cycle Mgmt
Excelsior Orthopaedics, 3921 Sheridan Drive, Amherst, NY 14226 

Phone: 716-250-6402
Fax: 716-650-6555
Email: [email protected] 

You may file a grievance in person or by mail, fax, or email. If you need assistance filing a grievance, the Civil Rights Coordinator listed above is available to help you. 

Filing a Civil Rights Complaint with HHS 

You may 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 

• By Mail or Phone: 

U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201 

Phone: 1-800-368-1019
TDD: 800-537-7697 

Complaint forms are available from the Office for Civil Rights. 

This notice is available on Excelsior Orthopaedics LLP’s website: www.excelsiorortho.com