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Employee Statement Form

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It is in any company's best interest to clearly document the actions taken to address any employee allegations of discrimination or harassment. In the past fiscal year, the federal EEOC (Equal Employment Opportunity Commission) filed charges against 75,768 companies for harassment or discrimination. In the majority of those cases, the employer had no documented procedures for investigating reports of discrimination or harassment.

The Employee Statement Form allows employers to clearly document the report of an alleged incident accurately, without embellishment. A supervisor using this form will avoid common mistakes such as promising complete confidentiality or leading the witness.


Product Specifications:

  • This form is 8.5” x 11”
  • 50 sheets/pkg

SKU: FED625
Weight: 0.60
Price: $19.95



Alleged Harasser

Harassment Incident Report Form

Harassment Incident Resolution




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