Workplace Bullying or Harassment Complaint Form
Workplace Bullying or Harassment Complaint Form
|Name of person making the complaint: |Company: |
|Name of person complaint is against: |Company: |
|Date of complaint: |Location: |
|Date of investigation: |Person(s) investigating: |
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|Person interviewed |Other people involved |Description of the situation (dates, words, actions, |
| |(e.g., alleged bully, witnesses) |etc.) and impact |
| | |(e.g., humiliated, intimidated) |
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|Based on the investigation, did workplace bullying and harassment occur? |
|Yes No |
|Reason(s) for this conclusion |
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|Supervisor/Manager Signature: |Date: |
|Copies: person making complaint, manager, |
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