Form Title

File a Discrimination Complaint

Filing Type
The person making the complaint of discrimination.
Name information
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Address Group: Your Address
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City/State/Zip
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Preferred Communication

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Attorney Hiring Information
Note: You do not need an attorney to file a complaint.
Complainant/Attorney's Contact Information

Attorney Contact Information

Name information
Address Group: Complainant's Contact Person
City/State/Zip
Phone
Email

Respondent

The employer, housing provider, business, or City of Madison agency you believe discriminated against you. Note: if you wish to file a complaint against more than one Respondent, please submit an additional form. One Respondent can only be investigated per complaint. If you have questions, please call us at (608) 266-4910.
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Address Group: Respondent's Address
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City/State/Zip
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Phone
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Phone

Complaint Information

This complaint is about
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I believe I faced discrimination because I belong to the following protected class(es):
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(Minimum 35 characters)
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What do you hope to get out of this process?
You will have the opportunity to submit electronic documentation of your complaint at a later time.
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Signature Information
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By signing below, I hereby agree to comply with the Equal Opportunities Commission Rules and to fully participate in the investigation of this complaint. I am aware that failure to do so may result in the dismissal of the case.

Date Signed
CCP Use
Submit
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