EEO Complaint Appointment Scheduling Form
Schedule an appointment to discuss your Equal Employment Opportunity complaint confidentially with our office.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Department or Work Area
*
Please Select
Human Resources
Operations
Sales
IT
Other
Position/Job Title
Preferred Appointment Date and Time
*
Type of Complaint
*
Discrimination
Harassment
Retaliation
Other
Brief Description of Your Complaint
*
Have you previously reported this issue?
*
Yes
No
Preferred Method of Contact
*
Email
Phone
Additional Comments or Information
Schedule Appointment
Should be Empty: