City of Topeka | Human Relations Commission: Online Report Form

The online form below is part of our intake process only. Your complaint will not be investigated or officially filed until you have signed a complaint form. An HRC intake officer or investigator will contact you with in 3 business days to complete your intake process. If there are any issues concerning HRC’s jurisdiction in this matter, you will be informed by mail within 7 business days.

Please enter only the minimal information concerning your complaint. Additional details for your complaint will be collected by an investigator as needed in the future.

Personal Information

Your Name Time to Call

Daytime Phone No Evening Phone No

City ST Zip Code

Who else can we call if we cannot reach you?

Contact's Name Daytime Phone No

Best time to call Evening Phone No

Enter Public Accommodation Complaint Information

What happened to you? How were you discriminated against?
Examples: Were you denied service in a restaurant because of your race? Refused an opportunity to enter a business because you have a service animal? Told that you would not be provided a service because of your religion? Could not receive service because of a physical barrier?

State briefly what happened

Why do you believe you are being discriminated against?
Examples: Were you denied service in a restaurant because of your National Origin? Refused an opportunity to enter a business because of your color? Told that you would not be provided a service because of your sex? Treated differently from others because of you have a disability? It is a violation of the law to discriminate for any of the following factors: Race, Color, Religion, Sex, National Origin, Disability.

Who do you believe discriminated against you?

Where did the alleged act of discrimination occur?

Address City ST Zip

Type of Business
Examples: restaurant or tavern, clothing store, transportation service, shopping mall, cleaners, etc.

When did this act of discrimination occur?

Enter the date mm/dd/yyyy

Is the alleged discrimination continuous or on going?

Do you have any witnesses to the alleged acts of discrimination?