DIHAC

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Sexual Harassment

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Have you experienced unwanted sexual remarks, requests for sexual favors, sexual advances, touching or other sexual conduct on your job (“sexual harassment”)?

Has the “sexual harassment” taken place within the last 3 years?

Does your employer have a written policy prohibiting sexual harassment in the workplace?

Which best describes the person who sexually harassed you?

Did you report the sexual harassment to one of the following:

Did your employer investigate your complaints of sexual harassment?

Did your employer take any actions to stop the sexual harassment?

Did the sexual harassment continue after you reported it?

Have you been terminated from your job?

Has your employer altered your job responsibilities, decrease your pay, hours or compensation, or retaliate against you?

Did the sexual harassment interfere with your ability to perform your job?

Did the sexual harassment cause you to miss time from your job?

Did you voluntarily quit or resign from your employment because of the sexual harassment?

Choose the category that best describes your yearly income:

Have you suffered from any physical or psychological conditions or symptoms as a result o the sexual harassment?

Is the sexual harassment still continuing today?

Prior to experiencing any sexual harassment in the workplace, were YOU ever suspended, reprimanded or given warnings by your employer?

To the best of your recollection, was the information provided on your employment application accurate?

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