In addition to clearly defined, trauma-responsive workplace policies on domestic violence, sexual violence and harassment, and stalking, employers can offer documentation procedures and complaint forms to respond more thoughtfully to incidents of violence or harassment that occur within or are related to the workplace.
Documenting an Incident
It is critical to document an incident of violence or harassment to be able to address it in a supportive and responsive way. The most important information to gather when documenting violence is:
- Who was/were the perpetrator(s)?
- What was said/done/shown?
- When and how frequently did any incidents occur?
- Where did the incident(s) occur?
- Who else may have witnessed the incident(s)?
- Did the target of the incident tell anyone else what happened?
Workers can write this information down to set a timeline of events and keep a record of how the harassment or violence occurred, which can be hard to remember when dealing with the trauma that comes from such experiences.
Another way to gather this information in one place is through DocuSAFE. Created by the National Network to End Domestic Violence (NNEDV), DocuSAFE is a free app to collect, store, and share evidence of abuse; such as domestic violence, sexual assault, stalking, online harassment, or trafficking. Survivors can log individual incidents through photos, screenshots, or video documentation of threatening messages, harassing social media posts, unwanted repeated phone calls, or online impersonation, among other behaviors into a secured cloud-location.
For more information about DocuSAFE and its use for survivors, advocates, and courts, including confidentiality and evidence in legal proceedings, check out the guide for survivors here.
Model Reporting Form
If you believe that you have been subjected to domestic violence, sexual violence, sexual harassment and/or stalking, you are encouraged to complete this form and submit it to [person or office designated] at [contact information for designee or office] via [mode of form submission]. [Employer] will not retaliate against you for filing a complaint.
Complainant Information
Name:
Work Address:
Work Email:
Work Phone Number:
Job Title:
Supervisor Information
Immediate Supervisor’s Name:
Work Address:
Work Email:
Work Phone Number:
Job Title:
Complaint Information
Please describe the incident in as much detail as possible. If you are not sure who perpetrated the violence, write down any details about the person you can recall. You may use additional sheets of paper to attach any relevant evidence or documents (screenshots, text exchanges, etc.)
Description of incident:
Name:
Work Address:
Work Email:
Work Phone Number:
Job Title/Affiliation with [Employer]:
Please list any individuals/witnesses who may have information related to your complaint, and indicate whether an authorized representative of _____________ [employer] would be able to contact them. You may use additional sheets of paper to add more individuals/ witnesses.
Name:
Work Address:
Work Email:
Work Phone Number:
Job Title (if a coworker):
Name:
Work Address:
Work Email:
Work Phone Number:
Job Title (if a coworker):
Name:
Work Address:
Work Email:
Work Phone Number:
Job Title (if a coworker):
If you have retained legal counsel, have complained to your union, or are working with an advocate, and would like us to contact them, please provide the information below and indicate your agreement by signing below.
Legal Counsel/ Union Representation
Name:
E-mail Address:
Phone Number:
SignatureDate
[Employer] is committed to following all of the steps outlined in the workplace policy on Domestic Violence, Sexual Violence and Harassment, and Stalking in order to build a safer and more supportive organizational climate.* This report of an allegation of violation of this policy will be immediately investigated in accordance with the timeline and procedure outlined in the workplace policy.
*NOTE: When you receive this form from an employee, be sure to share the community referrals and resources list or information to the employee in order to assist with their concerns or experiences regarding violence.