Sexual Harassment Report Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Report Date *Epmloyee Name *Employee Dept *Description of the Event (Date, Location, Behavior, etc., Who, What, When, Where, How. Attach signed employee handwritten or typed statement.)1. Witnesses (Names, Departments, Location during the Incident, etc.)2. Witnesses (Names, Departments, Location during the Incident, etc.) 3. Witnesses (Names, Departments, Location during the Incident, etc.)4. Witnesses (Names, Departments, Location during the Incident, etc.)5. Witnesses (Names, Departments, Location during the Incident, etc.) Has the employee reported the incident to his or her manager, supervisor, team leader?YesNoHas the employee discussed the incident with anyone other than his or her immediate supervisor?YesNoOther Employee Comments, Insights, Pertinent Facts, etc.Does the employee understand that the matter will be fully investigated?YesNo employee Witnesses Pertinent Employee Name *Recorder Name *Submit
