Discrimination Reporting Form

Have you been discriminated against based on your sexual orientation or gender identity?  Has someone used his or her religious beliefs as a basis for turning you away from a business or denying you service at a federal, state, or local government agency?

1. If so, tell us what happened, when it happened, and who specifically was involved.  For example, say the event happened in X city.  But be even more specific and let us know if it was the county clerk, the name of the business, or the Social Security Administration, as examples. 

2. Include your EMAIL ADDRESS.  If you would also like to provide your phone number, that is fine, too.  But definitely include your email address.

In some cases, we MAY be able to help you find legal resources and in others we MAY be able to help you advocate with the discriminating party to resolve the situation.  Thank you for coming forward to report your incident.