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LGBT Harrassment Complaint Form

This form is used to report incidents of harassment or discrimination faced by the LGBTQ community. Information that is collected on this form will be used to investigate the incident and take appropriate action.

Time to complete

3 minutes

Eligibility

The LGBT harassment complaint form is filled by members of the LGBT community who have experienced harassment at the workplace or elsewhere.

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Questions for LGBT Harrassment Complaint Form

1.

Full Name

The answer should be a text input.
2.

Age

The answer should be a single choice:
  1. Under 18
  2. 18-24 years old
  3. 25-34 years old
  4. 35-44 years old
  5. 45-54 years old
  6. Over 55
3.

Date of Birth

The answer should be a date input.
4.

Phone Number

The answer should be a phone number.
5.

Email Address

The answer should be an email input.
6.

Home Address

The answer should be a text input.
7.

Nationality

The answer should be a country.
8.

How do you identify yourself?

The answer should be a single choice:
  1. Lesbian
  2. Gay
  3. Bisexual
  4. Transgender
9.

Are you filing this complaint on behalf of another individual? If so, please provide that individual's contact information.

The answer should be a text input.
10.

What is the nature of the harassment you have experienced? Please describe the incident(s) in detail.

The answer should be a text input.
11.

Location of alleged harassment

The answer should be a text input.
12.

Do you have any witnesses? If so, please provide their name, contact information, and relationship to you.

The answer should be a text input.
13.

Have you contacted the individual or organization against whom you are filing the complaint in an attempt to resolve the issue? If so, what was the outcome?

The answer should be a text input.
14.

Have you previously filed a complaint against this individual?

The answer should be a single choice:
  1. Yes
  2. No
15.

Do you have any other information that you believe would be helpful in investigating this complaint?

The answer should be a text input.
16.

Is there anything else you would like to add?

The answer should be a text input.

Similar Ideas

  • LGBT Harassment Complaint Form
  • Harassment Incident Report Form
  • Sexual Harassment Complaint Form
  • Workplace Harassment Complaint Form
  • Student Harassment Complaint Form Harassment Complaint Form - Schools Domestic Violence/Harassment Complaint Form

Here are some FAQs and additional information
on LGBT Harrassment Complaint Form

How do I file a LGBT Harrassment complaint?

You can file a complaint by filling out and submitting an LGBT harassment complaint form.

What information do I need to include in LGBT Harrassment complaint?

When you file a complaint, you will need to provide your contact information, as well as the contact information of the person or entity you are filing the complaint against. You will also need to describe the alleged harassment in detail, including dates, times, and locations.

How long will it take to process my complaint?

It will generally take our office 3-5 business days to process your complaint.

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