LCHR Public Accommodations Discrimination Intake Form

Please complete the entire form below and submit it. You cannot save your progress if you choose to submit your form online.

Click here if you wish to download a paper form to fill out and return to the Louisiana Commission on Human Rights (LCHR) instead of completing the online form.

This form asks for the basic information that we need to decide whether or not we can investigate your public accommodations-related problem. If you have difficulty understanding these instructions or have questions, contact our office at (225) 342-6969, and a member of our staff will assist you.

NOTE: The Louisiana Commission on Human Rights can only investigate discrimination that occurred within the past 365 days (one year).

According to Louisiana Law (LA R.S. 51: 2247), it is discriminatory practice for a person to deny an individual the full and equal enjoyment of the goods, services, facilities, privileges, advantages, and accommodations of a place of public accommodation, resort, or amusement, on the grounds of race, creed, color, religion, sex, age, disability or national origin.

Required Evidence

In addition to the statements regarding your belief of mistreatment, the Louisiana Commission on Human Rights will need information from other people and valid documents to investigate your complaint. This intake form includes questions about the people and documents that might help prove that any mistreatment you experienced violated (LA R.S. 51:2247). To be most useful to your complaint, the people you identify generally should have direct knowledge of how you were treated and/or information about how your treatment compared to that of other people.

Complete this form only if you believe you have been discriminated against because of one of the bases listed above. Please take your time to answer all questions completely and accurately.

Once we have received your form, our intake officer will review it and contact you. Completing this form does not mean you have filed a discrimination complaint.