3 minutes
Any person who is a victim of harassment can fill out a harassment complaint form. The victim can be male or female.
What is your name?
What is your age?
What is your gender?
What is your race or ethnicity?
What is your current relationship status?
What is your current job or occupation?
Have you ever experienced harassment?
If yes, please describe the incident or incidents in as much detail as possible.
When did the incident or incidents occur?
Where did the incident or incidents occur?
Who was the perpetrator or perpetrators?
Was the perpetrator or perpetrators known to you?
If yes, how were they known to you?
Have you taken any action in response to the incident or incidents?
What was the action taken?