Disability Info Release for Public Accommodations

Complete this form if you have a disability-related complaint. This form authorizes the release of information related to your disability to PA Human Relations Commission investigators.

Public Accommodations Access

Complete this form if lack of physical access because of a disability has denied you the services of a business or other public accommodation.

General Questionnaire

Complete this form if you were denied the services or offered different terms and conditions for services in a business or other facility based on your race, sex, religion, ancestry, disability, etc. This includes services provided by government entities, and any business or facility which is open to, accepts, or solicits patronage of the general public.