Language Access Initial Written Complaint Questionnaire (English)
Date/Update: March 3, 2025

Purpose:
According to the Language Access Act of 2004 (“LAA”), it is unlawful for DC government agencies, departments, programs, or their funded entities1 to prevent constituents with limited or no English proficiency from accessing services because of a language barrier. If you or someone you know is denied language access services, contact the DC Office of Human Rights to file a complaint. Please file this initial written complaint questionnaire by submitting it online, emailing this form to [email protected], or submitting this form by mail or in-person to 441 4th Street NW, Suite 570N, Washington DC, 20001. The Language Access Initial Written Complaint Questionnaire form is available on OHR’s website in Amharic, Chinese, French, Korean, Spanish, and Vietnamese. 

Instructions
When an initial written complaint questionnaire is filed, the Language Access Program Director will attempt to ensure that the complainant receives the language assistance they are seeking before launching a full investigation. The submission of a complete initial written complaint questionnaire preserves all rights for statute of limitations purposes. If you believe you have experienced a possible violation of the LAA, please complete the following form in its entirety to the best of your ability. This form is subject to review by the Language Access Director to determine the jurisdictional requirements have been met and acceptance by OHR. Fields marked with an asterisk (*) to the left are required fields and must be completed.