Louisville Metro Human Relations Commission LGBT Housing Discrimination Survey

A Louisville Metro Human Relations Commission community survey into incidents of potential housing discrimination against persons based on actual or perceived sexual orientation and/or gender identity.

* 1. Date (and time, if available/known) of incident

* 2. Location of incident

* 3. Basis of the incident (actual or perceived sexual orientation and/or gender identity)

* 4. Describe the incident

* 5. Any agency or advocacy group contacted? (if so, please provide the name and action taken, if any)

* 6. Incident reported to media?

* 7. Organization or individual reporting the incident (name, address, telephone)

* 8. Witness(es) to the incident (if any: name, address, telephone)

* 9. Would you like the Louisville Metro Human Relations Commission to contact you?

* 10. Your contact information

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