If you would like to seek further advice from our Discrimination Team please complete the below form and a member of the team will be in touch.
Name
Address
Date of Birth
Email
Contact No
Type of Discrimination
—Please choose an option—AgeDisabilityGender reassignmentMarriage and civil partnershipPregnancy and maternityRaceReligion or beliefSexSexual orientation
Disability Detail (if relevant)
Day to Day Effects
Date and time of Incident
Defendant name and address
Incident Circumstances
Witnesses
Details of any reports/Complaints
Any reoccurrences/further visits
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