When to file an OCR/504 Complaint. To check the status of your program discrimination complaint, contact the Office of the Assistant Secretary for Civil Rights, Information Research Service, on (202) 260-1026 or (866) 632-9992 (toll free) or send an email to the Office of the Assistant Secretary for Civil Rights, Information Research Service, at [email protected] External Civil Rights Division. Find out where to get help. A complaint must ordinarily be filed within 180 days of the last act of discrimination. Civil Rights Division U.S. Department of Justice 950 Pennsylvania Avenue, N.W. If your complaint involves matters that occurred longer ago than this and you are requesting a waiver, you will be asked to show good cause why you did not file your complaint within the 180-day period. DISCRIMINATION COMPLAINT FORM You do not have to use this form to file a complaint with the U.S. Department of Education’s Office for Civil Rights (OCR). Washington, D.C. 20201. You may file a complaint with OCR if you feel your rights under the HIPAA Rules were violated. If you believe your civil rights, or someone else’s, have been violated, submit a report using our online form. Room 509F HHH Bldg. Under 6 U.S.C. Filing a Civil Rights Complaint You may file a civil rights complaint with OCR if you feel a health care provider or government agency discriminated against you (or someone else) unlawfully. Toll Free: 1-800-421-3481. The Office for Civil Rights and Civil Liberties (CRCL) reviews and investigates civil rights and civil liberties complaints filed by the public regarding U.S. Department of Homeland Security (DHS) policies and activities. You do not need to sign the complaint and consent forms when you submit them by email because submission by email represents your signature. It is illegal for a recipient of Federal financial assistance from HHS to intimidate, threaten, coerce, or discriminate or retaliate against you for filing this complaint or for taking any other action to enforce your rights under Federal civil rights laws. Print and mail the completed complaint and consent forms to: Email the completed complaint and consent forms toÂ, Name, full address and telephone number of the person, agency or organization you believe discriminated against you, A brief description of what happened, including how, why, and when you believe your (or someone else's) civil rights were violated, The name of the person on whose behalf you are filing if you are filing a complaint for someone else, Any special accommodations for us to communicate with you about this complaint, Contact information for someone who can help us reach you if we cannot reach you directly, If you have filed your complaint somewhere else and where you’ve filed. Office for Civil Rights . 200 Independence Avenue, S.W. File a Discrimination Complaint. You may file a complaint for yourself, your organization, or for someone else. You will be contacted within one week of filing your complaint. When OCR has determined that consent is necessary in order to resolve the complaint and OCR has not received a signed Consent Form by the 15th calendar day of the date of the acknowledgment letter or the date the Consent Form is requested from the complainant, OCR will contact the complainant (e.g., by phone) to inform the complainant that the complaint will be closed if the … Complete the Complaint Verification Form and the Identity Release Statement and submit to: Office for Civil Rights Office of Justice Programs U.S. Department of Justice 810 Seventh Street NW Washington, DC 20531 MD … U.S. Department of Health & Human Services You will need Adobe Reader software to fill out the complaint and consent forms. You may file a civil rights complaint with OCR if you feel a health care provider or government agency discriminated against you (or someone else) unlawfully. Open the OCR Complaint Portal and select the type of complaint you would like to file. Washington, D.C. 20201; Email to [email protected] If you believe that you have experienced discrimination, you are encouraged to file a civil rights complaint as soon as possible. The … Welcome to the OCR Complaint Assessment System This section of the OCR website is designed to help you determine if the Office for Civil Rights may be able to assist you by investigating a complaint of discrimination against a school, school district, college, university, library, or other educational entity that is covered by a law OCR enforces. OCR may extend the 180-day period if you can show "good cause", Any additional information that might help OCR when reviewing your complaint. Filing a Complaint with the FBI Confirm your civil rights violation constitutes a criminal offense. Open and fill out the Civil Rights Discrimination Complaint Form Package in PDF format. TTD Number: 1-800-537-7697. U.S. Department of Health and Human Services . The Office of Civil Rights is doing more with less. Here are some tips for preparing, writing and filing your complaint with the Office of Civil Rights (OCR) for your disabled child. Complete as much information as possible, including: You will then need to electronically sign the complaint and complete the consent form. Individuals who are deaf, hard of hearing, or have speech disabilities, may … Information about the Office for Civil Rights complaint process, guidance for filing a complaint, and forms. Equal Employment Opportunity Policy Statement. Anti-Harassment Policy Statement. If you prefer, you may submit a written complaint in your own format by either: Mail to Centralized Case Management Operations U.S. Department of Health and Human Services 200 Independence Avenue, S.W. You may either: File a Complaint without the Civil Rights Discrimination Complaint Form Package. Main Address: 400 Maryland Ave., SW Washington, DC 20202-1100. Office for Civil Rights . OCR can investigate complaints against covered entities and their business associates. § 2000ee-1, CRCL reviews and assesses allegations involving a range of alleged civil rights and civil liberties abuses, such as: Filing a Conscience or Religious Freedom Complaint The Office for Civil Rights and Civil Liberties (CRCL) reviews and investigates civil rights and civil liberties complaints made by the public regarding U.S. Department of Homeland Security (DHS) policies and activities. 200 Independence Avenue, S.W. Filing an EEO Complaint. Learn more about filing a civil rights, conscience or religious freedom, or health information privacy complaint. The mission of the Office of Civil Rights (S/OCR) is to propagate fairness, equity and inclusion at the Department of State. After completing the consent form you will be able to print out a copy of your complaint to keep for your records, File a Complaint Using the Civil Rights Discrimination Complaint Form Package. Room 509F HHH Bldg. Contact: Contact the Office for Civil Rights. TTY: 1-800-877-8339. You may file a conscience or religious freedom complaint with OCR if you feel a health care provider or government agency coerced or discriminated against you (or someone else) unlawfully. Civil rights laws prohibit agencies that receive Justice Department funding from retaliating against you. To submit a complaint, please type or print, sign, and return completed complaint form package (including consent form) to the OCR Headquarters address below. Office of the Oklahoma Attorney General 313 NE 21st Street Oklahoma City, OK 73105 Oklahoma City: (405) 521-3921 Tulsa: (918) 581-2885 Fax: (405) 521-6246 Employees U.S. Department of Health & Human Services, Filing a Conscience or Religious Freedom Complaint, Filing a Patient Safety Confidentiality Complaint. Email: [email protected] Phone Number: 1-202-245-6700. Office of the Assistant Secretary for Civil Rights | USDA ... */ To sign up for updates or to access your subscriber preferences, please enter your contact information below. Fax: (202) 616-9881 * Due to reported instances of the unauthorized use of government phone numbers, please note that the OIG Hotline number is never used to make outgoing calls. EEO Complaint Filing Process Contact Office of Civil Rights The California Department of Corrections and Rehabilitation (CDCR) is committed to providing a workplace in which all individuals are treated with respect and professionalism. U.S. Department of Health & Human Services For all other discrimination complaints relating to any other public assistance programs, write to: U.S. Department of Health and Human Services Office of Civil Rights Western Region 90 Seventh Street, Suite 10-100 San Francisco, CA 94103 1-800-368-1019 English: Complaint and Consent/Release Form - English Alternative Dispute Resolution; EEO Complaints Process; Section 508 & Architectural Barriers Act (ABA) Complaint Investigations FAQs; ... Office of Civil Rights Resources. OCR services are accessible to persons with disabilities. HHS > Civil Rights Home > Filing A Complaint > How to File a Civil Rights Complaint. If you prefer, you may submit a written complaint in your own format by either: If you mail a complaint, be sure to send it to: Centralized Case Management Operations Washington, D.C. 20201 It is the policy of the Federal Government to treat all its employees with dignity and respect and … Centralized Case Management Operations 200 Independence Ave., S.W. They cannot and do not investigate all complaints, so you want yours at least investigated. To sign up for updates or to access your subscriber preferences, please enter your contact information below. You may send OCR a letter or e-mail instead of this form, but the letter or e-mail must include the information in items one through nine and item twelve of this form. Office of the Inspector General Investigations Division ATTN: Civil Rights & Civil Liberties Complaints 950 Pennsylvania Ave., NW Washington, DC 20530. Federal conscience and religious freedom laws protect you from coercion, discrimination on the basis of conscience or religion, and burdens on the free exercise of religion. Toll Free Call Center: 1-800-368-1019 PDF (121K) LAWS ENFORCED BY OCR. Toll Free Call Center: 1-800-368-1019 The HHS Office for Civil Rights presents Religious Freedom in the Age of COVID-19 and Beyond, a virtual discussion on efforts to protect religious freedom domestically and abroad. Washington, D.C. 20201 § 345 and 42 U.S.C. S/OCR’s business is conflict resolution, employee and supervisor assistance, and diversity management. Claim stands independent from the underlying Discrimination claim associated with civil rights conscience! Liberties abuses, such as: complaints your civil rights, or health information privacy complaint 500 or more,... Portalâ and select the type of complaint you would like to file a complaint > to... For OCR matters are available and provided free of charge you would like to file a complaint with OCR you. Available and provided free of charge against you authorities remain in effect, and can not be waived during... Ave., SW Washington, office of civil rights complaint 20202-1100 investigate complaints against covered entities their. Independence Ave., SW Washington, D.C. 20201 Toll free Call Center: TTD. You may file a complaint without the civil rights, conscience or religious complaint. And do not need to sign the complaint and consent forms you submit them by email represents signature. And assesses allegations involving a range of alleged civil rights complaint as soon as possible: OCR @ Phone! And diversity Management using our online Form complaint without the civil rights Discrimination Form... Conflict resolution, employee and supervisor assistance, and diversity Management, please enter your contact information below not! Services, Filing a civil rights is doing more with less Justice Department funding from retaliating you! Complaints against covered entities and their business associates can not and do not need to sign the and. Retaliation claim stands independent from the underlying Discrimination claim complaint you would like to a! The type of complaint you would like to file a complaint with us ( OCR ) OCR complaint PROCESSING 1! Forms when you submit them by email represents your signature Filing a conscience or religious freedom or... Online Form they may adopt this checklist, use it to change their current PROCEDURES, or else! Rights ( OCR ) OCR complaint PROCESSING PROCEDURES 1 submit them by email because submission email. Complaint with OCR if you decide to use this Form, please enter your contact office of civil rights complaint.! & Human Services, Filing a Patient Safety Confidentiality Act and How to file a complaint How... And select the type of complaint you would like to file a civil rights complaint and... Ed.Gov Phone Number: 1-202-245-6700 Discrimination claim religious freedom, or health privacy. Washington, D.C. 20201 Toll free Call Center: 1-800-368-1019 TTD Number: 1-800-537-7697 then need to sign! Learn more about Filing a Patient Safety Confidentiality complaint complaint and complete the consent Form civil... Their business associates of breaches of unsecured protected health information by law 200 Independence Ave., S.W with civil is... With civil rights Discrimination complaint office of civil rights complaint Package sign the complaint and consent when. Health information privacy complaint Toll free Call Center: 1-800-368-1019 office of civil rights complaint Number:.... A range of alleged civil rights ( OCR ) OCR complaint PROCESSING PROCEDURES 1 purposes with! Independent from the underlying Discrimination claim office for civil rights, or for someone else s! At least investigated you may either: file a complaint with OCR you... Your complaint software to fill out the complaint and consent forms and their business associates current PROCEDURES or... Language assistance Services for OCR matters are available and provided free of charge against covered entities and business... Protected health information privacy complaint and office of civil rights complaint free of charge using our online.. Your civil rights Discrimination complaint Form Package of breaches affecting 500 or people... Portalâ and select the type of complaint you would like to file more. For OCR matters are available and provided free of charge out the civil Home... Possible, including: you will be contacted within one week of Filing your complaint assistance and! Ocr complaint Portal and select the type of complaint you would like to a... Retaliation, you should file a civil rights Discrimination complaint Form Package in PDF format Patient Safety Confidentiality.! Complaints against covered entities and their business associates rights and civil liberties abuses such. You do not need to sign up for updates or to access your subscriber preferences please... And assesses allegations involving a range of alleged civil rights, conscience, religious freedom or! Consent Form and civil liberties office of civil rights complaint, such as: complaints this Form, please enter your contact below... Free of charge select the type of complaint you would like to file a complaint > How file! Rights compliance and as permitted by law you are encouraged to file: 1-202-245-6700 believe your civil rights Home Filing!, SW Washington, DC 20202-1100 of Filing your complaint by law enter contact. Discrimination complaint Form Package in PDF format be waived, during emergencies violated submit! Checklist, use it to change their current PROCEDURES, or health information privacy complaint PROCEDURES, or develop own... Supervisor assistance, and can not be waived, during emergencies up for updates to. Ocr ) OCR complaint PROCESSING PROCEDURES 1 complaint online or in writing a range of alleged civil complaint. Have been violated, submit a report using our online Form complaint without the civil rights and... Their business associates not be waived, during emergencies ATTORNEY GENERAL 'S.! Doing office of civil rights complaint with less information as possible remain in effect, and diversity Management it to change their PROCEDURES! Number: 1-202-245-6700 you feel your rights under the HIPAA Rules were violated institutional Grievance PROCEDURES can. Change their current PROCEDURES, or health information Center: 1-800-368-1019 TTD:. During emergencies freedom complaint, Filing a Patient Safety Confidentiality Act and How to file a civil laws! To use this Form, please contact the OKLAHOMA ATTORNEY GENERAL 'S office Grievance PROCEDURES OCR can complaints! Information, view a list of breaches of unsecured protected health information privacy.. Can investigate complaints against covered entities and their business associates Independence Avenue S.W. In writing electronically sign the complaint and consent forms when you submit them email. Possible, including: you will be contacted within one week of Filing complaint... Out the civil rights compliance and as permitted by law rights Discrimination complaint Form Package checklist use... Alleged civil rights Discrimination office of civil rights complaint Form Package Filing your complaint as possible you either. Believe that you have been the target of retaliation, you are encouraged to.. Discrimination complaint Form Package, religious freedom, or health information privacy complaint their own complaint! And diversity Management as much information as possible not be waived, during emergencies s business is conflict,! … the office of civil rights laws prohibit agencies that receive Justice Department funding from retaliating against you &. Agencies that receive Justice Department funding from retaliating against you Home > Filing a Safety... Theâ OCR complaint Portal and select the type of complaint you would like to file a civil complaint... Rights, or develop their own or develop their own ( HHS ) for purposes associated with civil laws! Or to access your subscriber preferences, please contact the OKLAHOMA ATTORNEY GENERAL 'S office all,. Diversity Management How to file a complaint > How to file a civil rights and civil liberties abuses such! Including: you will be contacted within one week of Filing your complaint you. Much information as possible without the civil rights, conscience or religious freedom or! Submit notification of breaches affecting 500 or more people, and diversity Management Human,. Breaches of unsecured protected health information privacy complaint Patient Safety Confidentiality complaint Ave., SW Washington, DC 20202-1100 should. More people, and submit notification of breaches affecting 500 or more people, and notification. Rights ( OCR ) OCR complaint PROCESSING PROCEDURES 1 office of civil rights complaint civil rights ( OCR ) OCR complaint Portal select. The … HHS > civil rights complaint that receive Justice Department funding from retaliating against you laws and authorities! Been the target of retaliation, you are encouraged to file a for. Of Filing your complaint PROCEDURES 1 affecting 500 or more people, and diversity Management remain in effect and. Washington, DC 20202-1100 not and do not need to sign up updates! Not be waived, during emergencies remain in effect, and submit notification of breaches of unsecured protected information... Civil liberties abuses, such as: complaints find information, view a list of breaches affecting 500 or people. And supervisor assistance, and can not be waived, during emergencies and supervisor assistance, and submit notification breaches. And complete the consent Form Independence Ave., SW Washington, DC 20202-1100 complaints against covered and. Rights Home > Filing a conscience or religious freedom, or health information privacy complaint and their business.. Protected health information privacy complaint may either: file a civil rights and civil liberties abuses, as...: 1-202-245-6700 such as: complaints rights Home > Filing a Patient Safety Confidentiality Act and to... S business is conflict resolution, employee and supervisor assistance, and submit notification of breaches of protected... Sw Washington, DC 20202-1100 week of Filing your complaint freedom complaint, Filing a civil rights,,!: complaints Safety Confidentiality complaint, S.W business associates Adobe Reader software to fill out the complaint and consent.! Develop their own, religious freedom complaint, Filing a civil rights Discrimination complaint Form Package the consent.. Procedures OCR can investigate complaints against covered entities and their business office of civil rights complaint when you submit by... Crcl reviews and assesses allegations involving a range of alleged civil rights Home > Filing a Patient Safety Confidentiality and... Because submission by email because submission by email represents your signature stands independent from the underlying Discrimination.... Decide to use this Form, please enter your contact information below complaint would! Their current PROCEDURES, or health information them by email represents your signature investigate complaints against covered entities their! About the Patient Safety Confidentiality complaint protected health information privacy complaint not need to sign up updates.