Civil Rights U.S. Department of Health & Human Services
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What information must be provided to file a civil rights complaint?

You may file electronically via the OCR Complaint Portal or use the Civil Rights Discrimination Complaint Form Package. (You will need to save the PDF forms.)

You may also file a written complaint. Please include the following:

  • Your name
  • Full address
  • Telephone numbers (include area code)
  • Email address (if available)
  • Name, full address, and telephone number of the person, agency or organization you believe discriminated against you
  • Brief description of what happened
  • How, why, and when you believe your (or someone else's) civil rights were violated
  • Any other relevant information
  • Your signature and date of complaint

For more information, see Filing a Complaint.

Content created by Office for Civil Rights (OCR)
Content last reviewed on November 19, 2015