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  • Res/discrimination Complaint Form(1).pdf - Act Human Rights ...

Get Res/discrimination Complaint Form(1).pdf - Act Human Rights ...

Discrimination Complaint Form Please complete this form in pen. If you do not understand any part of this form, or if you need assistance to put your complaint in writing, please call one of our staff.

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How to fill out the Res/Discrimination Complaint Form(1).pdf - ACT Human Rights online

This guide provides clear and supportive instructions on how to complete the Res/Discrimination Complaint Form for the ACT Human Rights Commission online. Whether you are making a complaint or acting on behalf of someone else, follow these steps to ensure your form is filled out correctly.

Follow the steps to effectively complete your complaint form.

  1. Press the ‘Get Form’ button to access the form and open it in your preferred online editor.
  2. Begin by filling out the section titled 'Person making the complaint'. Provide your first name, last name, address, telephone numbers, and email address. Indicate whether you are the person who experienced discrimination or if you represent someone else.
  3. If you are not the person who faced discrimination, fill out the details of the individual in the section provided. You will also need to specify your role as a parent, guardian, or representative.
  4. Complete the optional section regarding your identification as a person of Aboriginal or Torres Strait Islander descent, if applicable.
  5. List the details of your representative if you have authorized someone to act on your behalf. This will include their name, organization, and contact details.
  6. In the 'Complaint' section, describe what led to your complaint, including relevant dates, incidents, and individuals involved. Stick to factual information and avoid discriminatory language.
  7. Complete the 'Personal Attributes' section by indicating the attribute you believe is relevant to your complaint, such as age, disability, or race.
  8. Describe why you believe this attribute led to unfavorable treatment, providing as much detail as necessary.
  9. Specify the area of discrimination where the unfavorable treatment occurred, such as in employment or access to services.
  10. Outline the specific actions or incidents of unfavorable treatment and provide details about involved parties.
  11. Reflect on the effect this treatment had on you, noting any emotional distress or disadvantage experienced.
  12. Indicate what resolution you seek from your complaint.
  13. Sign and date the form to confirm your statements are true and to authorize action on your complaint.
  14. Review the entire form for completeness and clarity. Once finished, you can save changes, download, print, or share the form as needed.

Complete your discrimination complaint form online to ensure your voice is heard in the process.

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How to File a Civil Rights Complaint Be filed in writing by mail, fax, e-mail, or via the OCR Complaint Portal. Name the health care or social service provider involved, and describe the acts or omissions, you believe violated civil rights laws or regulations.

For more information or if you would like to file a complaint please clink on the WSHRC link above or call (800)233-3247 or (360)753-6770.

What is FRBP? FRBP facilitates the resolution of OCR complaints by providing an opportunity for the parties involved to voluntarily resolve the complaint allegation(s). FRBP is a form of mediation or alternative dispute resolution.

The U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) enforces federal civil rights laws, conscience and religious freedom laws, the Health Insurance Portability and Accountability Act (HIPAA) Privacy, Security, and Breach Notification Rules, and the Patient Safety Act and Rule, which ...

Call 360-902-6088 or 1-800-423-7233. Get a discrimination complaint form (F416-011-000) in English or in Spanish and other languages (F416-011-999). You can submit the form to our secure file upload.

If the Complainant is not satisfied with the agency decision, he or she can appeal to the EEOC Office of Federal Operations (OFO) or file a civil action in Federal court.

OCR evaluates the written information that it receives to determine whether it constitutes a complaint that is subject to further processing. If so, OCR determines whether it can investigate the complaint. OCR makes this determination with respect to each allegation in the complaint.

completing investigations? within 180 calendar days after the date a complaint is filed. In some cases, the deadline may be extended. is needed, it may be extended for up to 90 days.

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Get Res/Discrimination Complaint Form(1).pdf - ACT Human Rights ...
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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Help Portal
Legal Resources
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232