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PENNSYLVANIA HUMAN RELATIONS COMMISSION PUBLIC ACCOMMODATIONS DISCRIMINATION QUESTIONNAIRE 1. YOUR CONTACT INFORMATION Name Address Street Apt. City State Zip Code Phone Number: (H) (Cell) (W) May
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Begin by carefully reading each question on the questionnaire to ensure understanding.
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Provide accurate and truthful information in response to each question. If you are unsure about any question, seek clarification or assistance.
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Who needs a public accommodation discrimination questionnaire?

01
Individuals who believe they have experienced discrimination or unfair treatment in public accommodations, such as hotels, restaurants, stores, or other places open to the public.
02
Businesses, organizations, or institutions that offer public accommodations and are required to collect information on potential discrimination cases for legal or reporting purposes.
03
Regulatory agencies, human rights commissions, or other entities responsible for investigating and addressing public accommodation discrimination complaints may use these questionnaires as part of their investigative process.
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The public accommodation discrimination questionnaire is a form that businesses or organizations must fill out to report if they have been discriminating against people based on protected characteristics.
Any business or organization that provides goods or services to the public is required to file the public accommodation discrimination questionnaire.
To fill out the public accommodation discrimination questionnaire, businesses or organizations must provide information about their practices and policies regarding discrimination, as well as any complaints or lawsuits filed against them for discrimination.
The purpose of the public accommodation discrimination questionnaire is to identify and address instances of discrimination in public accommodations.
Businesses or organizations must report information about their anti-discrimination policies, any complaints or lawsuits filed against them, and any remedial actions taken to address discrimination.
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