Human Rights

HUMAN RIGHTS VIOLATION REPORT

If you believe your rights, or someone else's, have been violated, submit a report using our form below. If you or someone else is in immediate danger, please call 911 or local police. If you are reporting misconduct by law enforcement, local government or believe you have experienced a hate crime, please contact us immediately by calling +1 718-332-3177

First name

Last name

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Phone

Date of Incident

Time of Incident

Type of cmplaint

Discrimination based on my Roma identity

Police misconduct or excessive force

Discrimination in school

Discrimination by local government

Discrimination by national government

Discrimination by social workers

Other - Explain below

Please explain in detail how you feel your human rights were violated

Were there any witnesses? If yes, please provide their names and contact information.

Have you reported this incident to any other agencies? If so, please provide details.

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