If you believe you have been treated unfairly or denied access to housing, public accommodations (like restaurants or shops), or other opportunities because of your race, color, religion, gender, disability, or other protected status, this is the correct form.

This is for all discrimination or harassment claims that are not related to your workplace.

Please do not use AI to complete these fields, use your own words describing the events as completely as you can.

If you need help completing this form, please contact us.