Equality Florida

Help us by submitting a report of discrimination you've had to face. We can help connect you with resources to resolve the situation, and it helps inform our efforts fighting for a more just Florida.

Contact Information

Title

First Name

M.I.

Last Name

Suffix

Name of Person(s) involved:

We keep record of this form in an information database that is then used by activists in their effort to educate state, local and national politicians and business leaders about the need for equal rights for LGBT people. Is it okay if we use he names in this database, or would you prefer that we use a pseudonym (made up name)?

Okay to use names in database?

YES NO, please use different names

Send me breaking new/alerts on discrimination issue via email:

YES NO

Send me quarterly updates via mail:

YES NO

Mailing Address:

City:

State:

Zip:

Telephones:

Home: Work:
Cell: Pager:

Email address:

Best time to reach you, and where:

Demographic information (optional)

We keep statistics to help ensure that we are serving the entire community. Your answers to these questions are appreciated, but not required.

Legal information: Your Case

The purpose of this service is to provide you with information through which you can learn about resources that are available to you to help protect your legal rights and to assist you in locating a LGBT friendly attorney in your area, if necessary or upon your request. Our cooperating attorneys have agreed to provide you a free initial consultation, but have not agreed to represent you. If you and the attorney agree that the attorney will represent you, the terms of that representation must be negotiated between you and the attorney. I am not an attorney and cannot provide you with legal advice, but we do have staff attorneys with whom we can confer if necessary to determine how we can best assist you.

Name of Offender (if known):

(e.g. employer, Police, Business, Neighbor, Ex-husband, etc)

Where event occurred:

City:
County: State:

Date event occurred:

Briefly describe this issue:

Would you like to speak to an attorney about this incident to learn more about your rights?

YES NO

Submit your report to Equality Florida