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REPORT OF RETALIATION Date: To: Julia M. Nicki Shaman Compliance Administrator 221 N. Basally Street Suite 455 Chicago, IL 60601 1. Address: 2. Contact Number: Please let us know the best time and
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How to fill out a report of retaliation:

01
Start by gathering all necessary information: It is essential to document all relevant details regarding the incident of retaliation. This includes the date, time, and location of the incident, as well as the names of the parties involved and any witnesses present.
02
Begin the report with a clear and concise summary: Provide a brief overview of the retaliation incident. Describe the nature of the retaliation and its impact on you or others affected by it. Make sure to include relevant context and any previous incidents that may have led to this retaliation.
03
Provide a detailed account of the retaliation: Clearly outline the specific actions or behaviors that were considered retaliation. Be specific and objective in your description, avoiding personal opinions or judgments. Include any supporting evidence, such as emails, text messages, or witness statements, if applicable.
04
Explain the impact of the retaliation: Describe how the retaliation has affected you personally, as well as any negative consequences it may have had on your work or well-being. This could include emotional distress, physical harm, or damage to your reputation. Be honest and transparent about the impact to provide a comprehensive understanding of the situation.
05
Identify any policies or regulations violated: If your organization or workplace has specific policies or regulations regarding retaliation, identify and reference them in your report. This will help establish a clear basis for why the actions taken against you qualify as retaliation.
06
Include your desired outcome or resolution: Clearly state what you hope to achieve by filing this report of retaliation. It could be seeking disciplinary action against the responsible party, requesting protection from further retaliation, or requesting appropriate corrective measures to address the issue.

Who needs a report of retaliation?

Any individual who experiences or witnesses retaliation within a workplace or organization should file a report of retaliation. This includes employees, contractors, volunteers, and even customers or clients who may have been subjected to retaliation by a staff member. It is important for both victims and witnesses to come forward and document such incidents to ensure a safe and respectful working environment for all. Additionally, reporting retaliation can help hold individuals accountable for their actions and prevent further occurrences in the future.
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Report of retaliation is a formal report that documents instances of retaliation in the workplace.
Any employee who has witnessed or experienced retaliation in the workplace is required to file a report of retaliation.
To fill out a report of retaliation, employees can typically use a designated form provided by their company's HR department or follow specific reporting processes outlined in the company's policies.
The purpose of a report of retaliation is to document and address instances of retaliation in the workplace to ensure a safe and fair work environment for all employees.
Information such as the date, time, and details of the alleged retaliation, names of individuals involved, and any supporting evidence should be included in a report of retaliation.
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