Employee Services and Human Resource Development

Follow-up to Complaint Form

                                   

Today's Date 

Complainant Name( Please Print)            

 Phone Number(s) Home/Work         

 Address                        

    

 Division                                 

 Title            

 Department             

Date(s) the alleged incidents(s) occured:

DETAILS OF THE INVESTIGATION:

 

ANY ACTION HAS BEEN TAKEN?

REQUESTED ACTION TO BE TAKEN?

Investigated by:

  Date