Questionnaire - FASTER DRAFT

Harassment Complaint Letter

Reporting the Workplace Harassment
- Employee Details
- Employer's Details
- Details of Incident
- Miscellaneous
Complete the Document
- Format & Signatures

Employee Details

Indicate the employee's full name who files that workplace harassment complaint (Employee):
Indicate an Employee's full job title:

Employer's Details

Indicate the full name of the Employer:
Should this letter be addressed to a specific department within the Employer's organization?
- Yes
- No
Indicate the full name of that department:
Do you know the exact name of the person to whom this letter should be addressed?
- Yes
- No
!
A letter reporting workplace harassment could be addressed to:
- director;
- head of the compliance department;
- head of the human resources department, or
- any other person within an employer’s organization that is authorized to deal with that matter.
Indicate the full name of a person to whom this letter should be addressed:

Details of Incident

Indicate the full name of a person who is accused of workplace harassment:

!
This is a person an employee wishes to complain about.
How many incidents of workplace harassment does an employee wish to report?
- One incident
- Various incidents
!
Workplace harassment is unwelcome behavior or conduct in a work setting that demeans, humiliates, or intimidates an employee. It can be:
- verbal
- physical, or
- psychological.
Harassment could be based on factors such as race, gender, age, religion, or other protected characteristics.
Indicate the date on which the first case of workplace harassment took place:
Describe in detail a workplace harassment incident that took place and about which an employee wishes to complain:

!
Workplace harassment includes sexual harassment and harassment based on religion, nationality, disability, sex, or gender.
Describe in detail all workplace harassment incidents that took place and about which an employee wishes to complain:
Are there any witnesses (e.g., other colleagues, employees, or officers who work within the organization) who can prove events of workplace harassment?
- Yes
- No
Indicate the full name of a witness, as well as their job title and position within the employer's organization:
Describe in detail what a witness's reaction was towards a workplace harassment incident:

Miscellaneous

Describe in detail how workplace harassment has affected an employee emotionally and/or physically:
Describe in detail how the employee wishes this complaint to be dealt with by the employer:
!
An employee may ask an employer to deal with the submitted complaint in various ways:
- to request a public apology from the offender;
- to transfer the offender to another department; and many more.
It would be helpful to examine further an employer’s internal policies about workplace harassment to learn more about possible outcomes of such a harassment investigation.
Indicate the date on which this letter is being signed and signed by an employee:

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Product	Subtotal
Harassment Complaint Letter × 1	$7.99
Subtotal	$7.99
Total	$7.99
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Employee Details

Indicate the employee's full name who files that workplace harassment complaint (Employee):

Indicate an Employee's full job title:

Employer's Details

Indicate the full name of the Employer:

Should this letter be addressed to a specific department within the Employer's organization?

Indicate the full name of that department:

Do you know the exact name of the person to whom this letter should be addressed?

Indicate the full name of a person to whom this letter should be addressed:

Details of Incident

Indicate the full name of a person who is accused of workplace harassment:

How many incidents of workplace harassment does an employee wish to report?

Indicate the date on which the first case of workplace harassment took place:

Describe in detail a workplace harassment incident that took place and about which an employee wishes to complain:

Describe in detail all workplace harassment incidents that took place and about which an employee wishes to complain:

Are there any witnesses (e.g., other colleagues, employees, or officers who work within the organization) who can prove events of workplace harassment?

Indicate the full name of a witness, as well as their job title and position within the employer's organization:

Describe in detail what a witness's reaction was towards a workplace harassment incident:

Miscellaneous

Describe in detail how workplace harassment has affected an employee emotionally and/or physically:

Describe in detail how the employee wishes this complaint to be dealt with by the employer:

Indicate the date on which this letter is being signed and signed by an employee:

Select a document's format

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