Employee Reporting Portal Employee Reporting Portal Online Form Nature of the ReportIs this an anonymous report?YesNoPlease Provide Your Name First Last Email PhoneWho should reach out to you about this report? My Human Resources Representative My Immediate Supervisor Other If Other, Who? Are you reporting Harassment, Discrimination, Making a Complaint, or something else? Harassment Discrimination Both Harassment & Discrimination Complaint Other If Other, Please ExplainHarrasmentWhat type of Harassment did you experience? Written Verbal Physical Sexual Other If Other, Please Explain Please provide a copy of the written harassment or written text:Max. file size: 256 MB.Please describe the verbal harassment using direct quotes ""Please describe the physical harassmentType of Sexual Harassment Unwanted sexual touching Sexual assault Impeding or blocking the victim Requests for sexual favors Quid pro quo sexual harrassment Threats or intimidation Sexual suggestive gestures, expressions or illustrations Jokes, comments or epithets of a sexual nature Other If Other, Please Describe Please describe the harassment you experienced, and please describe the circumstances. Include any direct quotes, description of the location, and any witnesses (if possible)DescriminationType of Discrimination Age Sex Race Color Religion Sex (Including Gender Identity, Sexual Orientation, And Pregnancy) National Origin Disability Genetic Information Other If Other, Please Explain Please Describe the Discrimination you experienced, and please describe the circumstances. Include any direct quotes, description of the location, and any witnesses (if possible)Both Harassment and DiscriminationTypes of Discrimination and Harassment Unwanted sexual touching Sexual assault Impeding or blocking the victim Requests for sexual favors Quid pro quo sexual harassment Threats or intimidation Sexually suggestive gestures, expressions or illustrations Jokes, comments or epithets of a sexual nature.Jokes, comments or epithets of a sexual nature. Age Sex Race Color Religion Sex (Including Gender Identity, Sexual Orientation, And Pregnancy) National Origin Disability Genetic Information Other If Other, Please Explain Please Describe the Harassment and Discrimination you experienced, and please describe the circumstances. Include any direct quotes, description of the location, and any witnesses (if possible)ComplaintWho does the complaint concern? A Fellow Employee A Manager or Supervisor A Vendor or Contact It doesn't involve a person Other If Other, Please Explain What does the complaint involve? Health Safety Materials Tools Job Site Office Other If Other, Please Explain Please describe your complaintHow can your complaint best be resolved?Who would you like to contact you about your complaint? My Human Resources Representative My Immediate Supervisor The President The Head of My Department Do not contact me about this complaint Other If Other, Please Explain
