Abusive Conduct Complaint Intake Form

Abusive Conduct Complaint Intake Form

This form should be used to report alleged violations of the Abusive Conduct in the Workplace Policy. You can see the Abusive Conduct Policy further at: [LINK].

If Respondent (see definition to the right) is a non-employee student, or the Respondent is a student and the incident does not involve the student's employment, the Abusive Conduct Policy does not apply. You may report such incidents to the Center for Student Conduct for review under the Student Code of Conduct: [LINK]

Any questions regarding this form should be directed to Employee and Labor Relations (hradmin_elr@berkeley.edu).

If you are experiencing an immediate safety threat or emergency, please call 911 immediately.

Definitions

Reporter: Any individual, including a student, who makes a report of alleged Abusive Conduct.

Complainant: Any individual, including a student, who alleges and/or has been reported to have been subjected to Abusive Conduct.

Respondent: An individual alleged to have engaged in Abusive Conduct in the workplace (including student-employees).

Workplace: Any space where University business is conducted or occurs, in connection with University employment and/or in the context of a University program or activity.

Date of Incident*

If conduct has taken place on more than one date, please indicate the initial date here and include additional dates below in the Description of Conduct section.

Are you reporting for yourself or another?*

If you are reporting alleged Abusive Conduct on behalf of someone else, you may do so anonymously. However, UC employees reporting on behalf of a student or subordinate employee must provide their name and other information to fulfill their reporting responsibilities.

Select

Your Name*

Your Contact Information*

Please provide your preferred method of contact (e.g., phone number or email).

If you are reporting for another, is this person someone you supervise?*

Select

If you answered yes to the prior question, you must connect with your HR Partner prior to filing this report. Have you connected with your HR Partner?*

Select

Complainant Information

Each question below requires a response; if any of the requested information about the Complainant is unknown, please enter/select "Unknown."

Complainant Name*

Complainant Contact Information

Complainant Department*

Complainant Affiliation*

Select

Complainant Classification*

Select

Is Complainant Represented or Non-Represented?*

Select

Complainant Bargaining Unit (Form)*

Select

Respondent Information

Each question below requires a response; if any of the requested information about the Respondent is unknown, please enter/select "Unknown."

Respondent Name*

Respondent Contact Information

Respondent Department*

Respondent Affiliation*

Select

Respondent Classification*

Select

Is Respondent Represented or Non-Represented?*

Select

Description of Conduct

Please provide a description of the behavior being reported.*

Your response could include, but is not limited to, the following: what occurred; when the incident occurred; where the incident occurred; who else was present at the time of the incident; etc.

If you need additional space to describe the behavior being reported, please attach the details in a file below.

Please submit any supportive documentation here.

This includes, but is not limited to, documents, pictures, emails, screenshots of texts, etc.

Drag and drop files here or

Additional Information

Has this been reported to another office?*

Select

Which office(s) has this been reported to?*

Please indicate which office(s) this has been reported to (e.g., OPHD, Clery, Whistleblower, etc.).

Next Steps

After submitting this form, the submission will be reviewed by Employee and Labor Relations ("ELR") and we will be in contact with you.

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