WEDO Complaint Form

By completing this document, you certify that the information you are providing is true and accurate to the best of your knowledge. If requested, you agree to provide additional information regarding this complaint. You understand that providing false or misleading information is grounds for discipline up to and including termination from employment. You further understand that we cannot guarantee complete confidentiality where it would conflict with our obligation to conduct a meaningful investigation or, where warranted, take corrective action.

Your Name

Your Email Address

Your Phone Number

Are you an Employee?

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Type of Complaint

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Please specify

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Date of last incident

Who is the complaint against

Is this person an employee?

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Injured Party (if other than yourself)

Please describe the incident

Any Witnesses?

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Please list witnesses and contact information

Is the issue ongoing?

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What resolution are you seeking?

Send me a copy of my responses

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