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Service Request Type:
Human Rights Discrimination Inquiry
Your Email Address:
Victim name:
Victim address:
Victim phone number:
Victim e-mail address:
Area of discrimination:
*
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Please describe :
Type of discrimination:
*
Race
National Origin
Age
Disability
Religion
Retaliation
Color
Creed
Sexual Orientation
Family Status
Marital Status
Sex
Gender Identity
Housing Choice Voucher
Other
If other, please describe:
Issue:
*
Policy/process concern
Communication barrier
Conflict navigation
Barrier to meeting basic needs
Training request
Other
Name of person who discriminated against you:
Address of person who discriminated against you:
Date when the discrimination occurred:
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August 2022
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Today
Clear
Summary of what happened:
*
Additional Departments Involved:
Building Services
Health Services
Housing
Legal
Parking
Police Department
Public Works
Other
Education Session:
Education on civil rights law coverage
Education on how to request/respond to reasonable accommodation
Education on general employment law
Education on general landlord/tenant law
If other, please describe:
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