Intake

Intake

Do you or someone you know need assistance with a civil rights issue? Fill out the form below and we will contact you.

"*" indicates required fields

Please be sure to include key information such as: when your issue happened, who your complaint is against, and how you think we can help.
Name*
Location*
e.g., race, disability, gender, national origin, etc.
This field is for validation purposes and should be left unchanged.