Harassment Complaint Investigation Form

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									Harassment Complaint
Investigation Form
Harassment at the workplace is a serious issue for small businesses. Small businesses
must ensure that they properly investigate and probe employee harassment claims to
provide a safe and professional working atmosphere. In addition, small businesses that
do not properly investigate harassment claims can expose themselves to legal liability.
Small businesses should use this Harassment Complaint Investigation Form to properly
and diligently investigate harassment claims.
                           Harassment Complaint Investigation Form

                                         EMPLOYEE INFORMATION

Name of Complainant: ______________________________

Complainant Employee I.D. #: ________________________________

Complainant Employee Department: _________________________________

Complainant Employee Title: ________________________________

                                          DETAILS OF COMPLAINT
Date Complaint Filed: ______________________________
Received By: ______________________________
Complaint Filed Against:
Employee Name: ______________________________
Employee Department: ______________________________
Employee Title: ______________________________
Nature of Complaint:

______________________________________________________________________________
______________________________________________________________________________

Witnesses: ____________________________________________________________________
Supporting Documentation: _____________________________________________________

                                        INVESTIGATION SUMMARY
Investigated By: ______________________________ Date of Investigation: ______________
Investigation Summary:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________




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                                           CORRECTIVE ACTIONS
Proposed Corrective Actions:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Corrective Actions Taken:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Approved By: _________________________________________

                                         PREPARER INFORMATION
Prepared By: ______________________________ Date: ______________________________

Preparer’s Signature: _________________________________




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