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Form Discrimination Harassment Complaint Company Hr Pdf
Form Discrimination Harassment Complaint Company Hr Pdf
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Discrimination and Harassment Complaint
SECTION 1: INSTRUCTIONS
Submit this form to the Oce of Human Resources Organization and Human Resources Consulting (OHRC) in person at:
1590 N. High St., Suite 300, Columbus, OH 43201-2190; via fax to 614-292-9223; or via email to sexualharassment@osu.edu.
A form can be requested by calling 614-292-2800 or on the Oce of Human Resources website at hr.osu.edu/forms.
If a faculty or sta member is notified of an allegation, he/she must refer the alleger or notify OHRC as soon as possible and no later
than five days after becoming aware of the allegation.
Filing an allegation of discrimination or harassment with the university does not preclude an alleger from filing an allegation
with an external agency nor does it extend time limits for such complaints.
SECTION 2: PERSON ALLEGING DISCRIMINATION/HARASSMENT
Employee’s Full Name: First M.I. Last
Department Title
Campus Mail Address
Campus Phone Email Address
SECTION 3: PERSON AGAINST WHOM ALLEGATION OF DISCRIMINATION/HARASSMENT IS BEING MADE
Employee’s Full Name: First M.I. Last
Department Title
Campus Mail Address
Campus Phone Email Address
SECTION 4: PERSON REFERRING THE COMPLAINT (if dierent from person alleging discrimination/harassment)
Employee’s Full Name: First M.I.
Last
Department Title
Campus Mail Address
Campus Phone Email Address
Using the space below and/or additional attachments, describe the events and/or behaviors that are the subject of the complaint.
Include any oces or individuals you’ve talked with on campus, the names of witnesses, as well as dates, times and locations.
Oce of Human Resources, DHC001, rev. 3/14 Discrimination and Harassment Complaint, Page 1 of 1
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source: hr.osu.edu
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