Office of Human Rights

Forms

*Persons wanting to file a discrimination claim must fill out the “Discrimination Form”. In addition, you may required to fill out a second form depending on the issue. Please follow instructions below.

• Discrimination Form
  Submit this form for every discrimination issue. This includes: discrimination in the sale or rental of housing and mortgage lending; discrimination in the workplace and covers recruitment, selection, promotion, transfer, pay, tenure, discipline, discharge and privileges.
• Public Reasonable Accommodation and Disability Grievance Form
  Submit this form for any discrimination issues regarding disabilities in public accommodations, employment and transportation, state and local government services and telecommunications, or public accommodation. *Must also fill out discrimination form above.
  
• Denial of any government assistance or programs
  Submit this form for discrimination issues regarding persons who believe they have been unlawfully denied access to or participation in programs services or activities provided by Pinellas County. *Must also fill out discrimination form above.
  
• Florida State Courts System Accommodation Form
  Request for reasonable accommodations if you are a defendant, litigant/party, witness, juror, victim or attorney. Submit this completed form at least seven (7) days before your scheduled court appearance or other court activity.
• Florida State Courts System Interpreter Request Form
  Request for interpreter if you are a defendant, litigant/party, witness, juror, victim or attorney. Submit this completed form at least seven (7) days before your scheduled court appearance or other court activity.
• Wage Theft and Recovery Complaint Form
  A complaint form for wage theft and recovery.