Technical Assistance Questionnaire for Public Accommodation
The primary purpose of this questionnaire is to solicit information about claims of discrimination, determine whether the Florida Commission on Human Relations (FCHR) has jurisdiction over those claims and provide charge filing counseling, as appropriate. Providing this information is voluntary, but the failure to do so may impede the Commission’s investigation of a charge. It is not mandatory that this form be used to provide the requested information. NOTE: The FCHR may disclose the information included on this form to other state, local and federal agencies, as appropriate or necessary to carry out the Commission’s functions, or if the FCHR becomes aware of a civil or criminal law violation. If the FCHR accepts this form as a charge, this form will be provided to the organization identified.
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Your answers to this questionnaire are confidential pursuant to Florida Statute 760.11(12).
Please complete this entire form and submit it to the Commission at the end of this form. Answer all questions completely. If you do not know the answer to a question, answer by stating “not known.” If a question is not applicable, type “N/A.”
REMEMBER, a charge of Public Accommodation discrimination must be filed within 365 days of the alleged act of discrimination.