Somerville Fair Housing Commission Complaint and Referral Form

Somerville Fair Housing Commission Complaint and Referral Form
The City of Somerville Fair Housing Specialist accepts reports of Fair Housing discrimination experienced in Somerville, as well as requests for information. Fair Housing laws apply to anyone looking to rent, buy, or sell housing located in Somerville, regardless of your current residency.

Please complete the form below as best you can, and then click SUBMIT. Fair Housing staff will respond within 3-4 business days of your submission.

For more detailed information on your Fair Housing rights and responsibilities please visit the Fair Housing Commission's webpage.
Name of Person Needing / Seeking Assistance*

First NameLast Name
Your Phone Number
Your Email Address
example@example.com
Preferred language(s) spoken by person needing / seeking assistance

EnglishSpanishPortugueseHaitian CreoleNepaliArabicHindiCantoneseMandarinOther
Address of the property where you believe you were discriminated against

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Why do you believe someone discriminated against you, someone you live with, or someone you sought to live with?

Please choose at least one reason. You can choose more than one.
Please select:

RaceColorNational originReligionGenderSexual orientationFamily status (e.g. have children)Source of income (e.g. Section 8)DisabilityOther
Are you the person who needs / seeks assistance?

YesNo, I am referring a family member, friend, neighbor, patient, constituent, etc.No, I have a question that I hope Fair Housing staff can answer
Referrer's Name*

First NameLast Name
Referrer's Phone Number
Please enter a valid phone number.
Referrer's Email Address
example@example.com
Referrer's relationship to person needing / seeking assistance
Should the Fair Housing Specialist follow up with you (referrer)?

Yes, please contact me before reaching out to the person I referredYes, please let me know whether you connect with the person I referredNo
In a sentence or two, please give us a brief explanation of what happened so that we can prepare the right resources for our follow-up call.

0/100
Should be Empty:

Somerville Fair Housing Commission Complaint and Referral Form

Why do you believe someone discriminated against you, someone you live with, or someone you sought to live with?