Sample letter for California employee to use when complaining about discrimination or harassment at workplace. Dear Ms. Bobblehead: Please allow this letter to serve as my complaint of discrimination against the U.S. Army.Learn the essential steps to prove workplace discrimination in California. Civil Rights Title VI Complaint Procedure. Any person who believes she or he has been discriminated against on the basis of race, color, or. • In writing: Fill out a complaint form or write a letter and send it to: Community Health Group. A description of why you believe you were discriminated against, such as because of your race, ethnicity, sex, age, disability, pregnancy, or other reasons. Complete an Online Complaint Form, or a hardcopy MS Word Complaint Form, as thoroughly and accurately as possible. (Telecommunications Relay Services). If you cannot speak or hear well, please call.