Have you experienced discrimination because of your vaccination status?
Please take a moment to fill out the form and share your story! We would like to start documenting discrimination to get an idea of the extent here in the Hoosier state.
This information will be used to illustrate the problems here in Indiana. When presented the information will be FREE OF IDENTIFYING INFORMATION. The only reason we ask for contact information is to help reduce duplicates, and so that we can follow up with you if needed. We promise not to share your information without your consent.
When you complete the form please include the following in the comments section:
This information will be used to illustrate the problems here in Indiana. When presented the information will be FREE OF IDENTIFYING INFORMATION. The only reason we ask for contact information is to help reduce duplicates, and so that we can follow up with you if needed. We promise not to share your information without your consent.
When you complete the form please include the following in the comments section:
- Date of occurrence
- Details of location
- Details of Discrimination
- End result: (denied job, were able to get exemption, switched providers etc etc)
- Anything else you would like us to be aware of.
