Free Startup Workplace Harassment Complaint Form Template
Startup Workplace Harassment Complaint Form
Ensure that all sections of the form are filled out accurately and thoroughly. Use checkboxes to indicate the nature of the harassment and any witnessed incidents. Once completed, submit the form to the designated contact person or department to ensure immediate response.
Personal Information
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Full Name: |
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Employee ID (if applicable): |
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Department/Team: |
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Date of Incident: |
Incident Details
Nature of Harassment
Please check the appropriate box or boxes that describe the nature of the harassment:
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Verbal Harassment
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Physical Harassment
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Sexual Harassment
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Cyberbullying
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Discrimination
Description of Incident
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Date |
Time |
Location |
Description of Incident |
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January 14, 2055 |
2:30 PM |
Breakroom, 3rd Fl |
[Offender Name] used offensive language, making derogatory comments |
Witnesses Information
If there were any witnesses to the incident, please provide their names and contact details (if known).
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Witness 1
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Name: |
John Miller |
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Contact Number: |
john@email.com |
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Witness 2
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Name: |
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Contact Number: |
Your complaint will be handled with the utmost confidentiality. Please be assured that we will take the necessary steps to investigate and address the matter appropriately. If you have any further questions or concerns regarding this complaint form, please contact [Contact Person/Department] at [Contact Person/Department Email]. Thank you for bringing this matter to our attention.
