How to Write a Harassment Report Complaint Form. Write a harassment report complaint form that streamlines the procedure for disgruntled employees to notify management when they've suffered or witnessed harassment. Have your attorney complete a full legal review of the form before making it available to employees. Make sure you advise existing employees and new hires that the form exists and where to get it.
Create a new document entitled, "Harassment Report Complaint Form." Add a short introduction defining harassment as any employee's visual, physical or verbal conduct toward another employee that interferes with the employee's working environment and job duties.
Make a section at the top of the form for information on both the complainant and alleged assailant. Request full names, job titles, business telephone numbers, employee status and unit assigned to for both individuals.
Have the complainant describe his relationship to the alleged assailant. Ask whether the alleged assailant is a co-worker, friend, supervisor, subordinate, trainer or trainee.
Require complainant to describe the alleged harassment in precise terms. If the harassment was verbal, require the complainant to write down verbatim the entire conversation. If harassment was physical, have the complainant describe the conduct with specificity.
Include a section for complainant to depict the physical circumstances of the alleged harassment. Request the date, time, location and names of witnesses, if any.
Continue preparing the form by making a separate section where complainants must identify whether the subject ever happened before. Follow this by requiring complainant to identify when, where, whether he reported the conduct to authorized personnel and to name those personnel.
End the form with a section asking complainant to describe the effects of the harassment. Ask whether the complainant sought medical attention and to identify medical personnel contacted, if any. Add two dated signature lines for the complainant and the human resources employee authorized to receive and review the harassment report complaint form.