did your company give your employee the tools to combat workplace bullying

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Date: February 20, 2015
Workplace Bullying or Harassment Complaint Form
Name of person making the complaint: Company:
Name of person complaint is against: Company:
Date of complaint: Location:
Date of investigation: Person(s) investigating:
Person interviewed
Other people involved
(e.g., alleged bully, witnesses)
Description of the situation (dates,
words, actions, etc.) and impact
(e.g., humiliated, intimidated)
Based on the investigation, did workplace bullying and harassment occur?
Yes No
Reason(s) for this conclusion
Supervisor/Manager Signature: Date:
Copies: person making complaint, manager,