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County Counsel

Discrimination Complaint Form

Discrimination Complaint Form

Attention: This is not intended for emergency situations. If your life or property is at risk, please call 911.

Any person who believes that they have been subject to unequal treatment or discrimination by a Clackamas County employee, contractor, or subcontractor has the right to file a complaint against Clackamas County. This form is intended for members of the public. If you are a Clackamas County employee filing a complaint about a work-related matter, please contact your HR representative.

Your complaint will go to the Civil Rights Coordinator in the Office of County Counsel. Please see the Title VI Compliance Plan for more information on the complaint process.

Please complete this form if you have reason to believe Clackamas County has discriminated against you on the basis of:

  • Race
  • Color
  • National Origin
  • English proficiency
  • Religion
  • Disability
  • Gender/Sex
  • Sexual orientation
  • Gender Identity or expression
  • Marital status
  • Veteran status
  • Source of income
  • Any other basis prohibited by federal, state, or local law

This is an administrative process that does not provide for compensatory or punitive damages. Filing this complaint does not prevent you from filing a complaint with other state or federal agencies or courts. There are time limits that apply to the filing of complaints. Generally, federal agencies require that Title VI complaints be filed within 180 days of the discrimination.

If you need language or accessibility assistance, please contact County Counsel at 503-655-8362.

Completed forms will not be processed until the Civil Rights Coordinator has verified the identity of the complainant and the intent to proceed with the complaint.

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Personal Information

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Complaint Information

They were a:
Do you know if a supervisor or manager is aware of the situation?
What is the race of the person discriminated against? (Check all that apply.)
What is the sexual orientation of the person discriminated against?
What is the gender identity of the person discriminated against?
Does the person discriminated against have a disability?
What do you believe is the reason or reasons for the discrimination? (Check all that apply.)
Did you file this complaint with another agency or court? (Check all that apply.)
Will you need the assistance of an interpreter?

Confidentiality Waiver

It is county policy to keep the information you provide on this form confidential to the best of our ability. Please be aware that information may still be subject to public records requests under Oregon’s Public Records Law.
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