Human Rights and Equity Programs

Fairfax County, Virginia

CONTACT INFORMATION: Our office is open 8AM-4:30PM M-F. For your convenience, our office accepts walk-ins for intake from 9 a.m. - 2 p.m on MWF.

703-324-2953
TTY 711

12000 Government Center Parkway, Suite 318
Fairfax, VA 22035

Kenneth Saunders,
Director

File an Employment Discrimination Complaint

Please be advised that by completing this form and returning it, you have not filed a formal complaint as required under the Fairfax County Human Rights Ordinance. Upon receipt of your completed form, commission staff will review your form and contact you to finalize the process.

Who was discriminated against?

NOTE:  If the person discriminated against is 18 or older, we will need that person’s signature before we can proceed with this complaint.
 
How many employees does your business have?
I believe that I have been discriminated against because of my (check all that apply):
For each action, you need to provide the following information:

a. Date (s) the discriminatory action occurred;
b. Name(s) of individual(s) who discriminated (include position, title);
c. What happened;
d. Witnesses, (if any);
e. Why you believe the discrimination was because of the reason you indicated above, or why you believe the action was retalitory.
Do you have documents that you think will help us understand your complaint? (If yes, you will be contacted with instructions for submitting this information. Do not send original documents.)
Please be advised that by completing this form and returning it, you have not yet filed a formal complaint.  Upon receipt of your completed form, commission staff will review and contact you to finalize the process.
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