Report An Incident
If you believe that you or someone you know has been the victim of racial or religious discrimination, please report it by filling out this form or by calling the CAIR-Georgia legal line at 404-239-2086. Note: Due to the volume of legal requests we receive, CAIR-Georgia’s policy is to respond to all non-urgent messages within three to four business days. If we deem this to be an urgent matter, someone in our Legal Department will attempt to contact you by the end of the day.
Today's Date
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Information About Person Completing This Form
First and Last Name
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Phone Number
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Email Address
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Are you calling for yourself or someone else?
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Have you (or the person seeking assistance) contacted another attorney or organization regarding your concern? If yes, who, and when?
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Information About Person Seeking Assistance
First Name
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Last Name
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Which language are you comfortable communicating in?
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Street Address
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City
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State
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Zip Code
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Phone Number
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Email Address
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Information About Incident
Date of Incident
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Briefly Describe the Incident.
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Demographic Information About Person Seeking Assistance
CAIR-Georgia is a community- and philanthropy-funded organization. We report demographic information to our community and funders to keep them abreast of our work and to continue to receiving funding for our legal work.
Date of Birth
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Gender
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Female
Other
Ethnicity
Education Level
Less Than High School
High School
Some College
Undergraduate Degree
Graduate Degree
Prefer Not to Disclose
Other
How did you hear about CAIR's services?
Have you contacted CAIR before? If yes, why, and when?
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How do you hope CAIR can serve you?
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Advice
Legal Representation
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Reporting Only
Disclaimer: This form is for general information purposes only. The submission and delivery of this form does not, in and of itself, constitute the formation of an attorney-client relationship nor any other contract between CAIR-Georgia or any legal person, entity, or group. Please be advised that the submission and delivery of this form does not thereby give rise to any of the legal or ethical protections of the attorney-client relationship with respect to any legal privilege or ethical duty running between client and attorney, including without limitation, the attorney client privilege. Please be mindful of any deadlines you have approaching that relate to your legal situation and seek advice of legal counsel because potential claims may become barred if not filed within the time provided by law.
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