Submitting this complaint questionnaire does not constitute the formal filing of a discrimination charge, but it serves to preserve all rights under the statute of limitations. The formal filing will take place when we review your questionnaire and hold an intake interview with you at the OHR Office.
How do you prefer we contact you?
Are you represented by counsel?
Respondent Company Address
Place where discrimination occurred:
Date of Occurrence *
Do you feel you were discriminated against because of your: (Please check appropriate box and provide detail, if necessary.)
What action was taken that made you feel you were treated differently?
Must be checked
.Must be checked
How did you hear about the DC Office of Human Rights (check all that apply)?
1. Complainant Information