EEO Investigation Interview Questionnaire Form
Please complete the EEO Investigation Interview Questionnaire Form to provide information relevant to the investigation. All questions are designed for EEO investigation interview purposes only.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Interview Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Your Role or Relationship to the Matter
*
Please Select
Complainant
Respondent
Witness
Supervisor/Manager
HR Representative
Other
Incident Description (please provide a summary of the incident or concern)
*
Names of People Involved (if known)
Witnesses (list any individuals who may have witnessed the incident)
Has this matter been previously reported? If yes, to whom and when?
Requested Outcome or Resolution
Submit
Should be Empty: