Breadcrumb Home Current page Case Report Discrimination General information Who is affected by discrimination: Myself Another person Gender of the person discriminated against: Incident When did the incident occur? Briefly describe what happened? Where did the incident happen? Who discriminated against the person? How did the conflict end? Reason for discrimination Why do you think the person was discriminated against? (Multiple answers possible) HIV infection Sexual identity Origin Gender Disability Age Outer appearance Language Religion/belief You have been discriminated against because you are in contact with a person with HIV (partner, friend) Other characteristics: Field of discrimination In which field were you discriminated against? (multiple answers possible) Healthcare (medical practices, hospitals, rehabilitation clinics, massage, physiotherapy ...) Work (workplace, job placement, labour market) Authorities/offices Police/Justice Public space (restaurant, club) Services/retail (insurance, tattoo parlour) Private area (sex partner, partner, family, neighbours, friends) Leisure (gym, club) Social networks Other Form of discrimination What form of discrimination is involved? (Multiple answers possible) Refusal of medical treatment Unequal treatment (e.g. unnecessary hygiene measures, restricted appointment allocation) Refusal of services Mobbing Threat Insult Criminal complaint Other Counselling I ask for counselling: Yes (Please enter your contact details only if you want us to contact you. Otherwise please leave it blank). Telephone number E-mail address If you want to report the case anonymously, please leave the fields blank! Privacy Privacy policy I agree. I have taken note of the data protection notice and agree to it. All information was provided voluntarily. CAPTCHA Math question 2 + 6 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Leave this field blank
