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Michigan Department of Civil RightsMichigan.gov, official Web site for the state of Michigan
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    Instructions for Making a Request

    Instructions for Making a Request:
  • This application allows you to initiate contact with MDCR to request program services.

  • Answering Questions:
  • You must respond to ALL questions marked by an asterisk (*) unless instructed otherwise.
  • Give complete request information to ensure a clear understanding of the request.
  • Submitting the Request Form:
  • When the system informs you to review the information that you have entered, select the "Submit" button after review is completed to submit your request.
  • If you exit before you select the "Submit" button, all information you have entered will be lost. Any notfications being sent by the system will be canceled.
  • After clicking the "Submit" button, wait for a confirmation page containing your confirmation number. Your request has not been accepted until you see the confirmation page.
  • Print the confirmation page or write down the confirmation number. Your confirmation number will be used to reference your request.
  • A MDCR Customer Service Representative will contact you to discuss your concern in detail.

  • Additional Notes:
  • Privacy: The information you provide to the Michigan Department of Civil Rights concerning your request for program services is confidential and will be used only by public officials performing their duties.
  • FOIA: The information you provide to the Michigan Department of Civil Rights concerning your request for program services is subject to the Freedom of Information Act (FOIA).
  • If you do not hear from a customer service representative within three (3) business days, please contact our Intake Unit at 1-800-482-3604 to protect the timeliness of your filing rights.

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