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Patient Informational:Last First MIE mail address:Mailing Address:Phone # (H)(W)(Other)Can we call you at work? Yes Notate of Birth:Sex: Male Female SS#:Marital Status: Single Married Divorced Widowed
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How to fill out sexual harassment and assault

01
Start by finding a quiet and private place to fill out the sexual harassment and assault report.
02
Title the report as 'Sexual Harassment and Assault Report' and include the date and time of the incident.
03
Provide your personal information such as name, contact details, and address.
04
Clearly describe the incident, including the date, time, and location of the incident.
05
Include specific details about the harasser or assaulter, such as their name, physical appearance, or any identifying information.
06
Describe the actions or behaviors that were considered harassment or assault.
07
Mention any witnesses who may have seen or heard the incident.
08
Attach any supporting evidence, such as photographs, messages, or emails related to the incident.
09
Provide a detailed account of any injuries or physical harm caused by the harassment or assault.
10
Finally, sign and date the report to confirm its accuracy and submit it to the appropriate authority or organization.

Who needs sexual harassment and assault?

01
Anyone who has experienced or witnessed sexual harassment or assault needs to report it.
02
Victims of sexual harassment or assault can use the report as a means to seek justice.
03
Organizations and authorities need sexual harassment and assault reports to take appropriate action against the perpetrators.
04
The information provided in the reports can help implement preventive measures to curb further incidents of sexual harassment and assault.
05
Society as a whole benefits from sexual harassment and assault reports as they contribute to creating a safer and more respectful environment.

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Sexual harassment refers to unwanted and inappropriate sexual advances or behavior that creates a hostile environment, while sexual assault is any non-consensual sexual act or behavior.
Typically, victims of sexual harassment and assault are required to file complaints, but witnesses and employers also have a responsibility to report incidents.
To fill out a complaint, victims should provide detailed information about the incident, including dates, locations, individuals involved, and any witnesses. Forms are usually available through HR departments or relevant authorities.
The purpose of addressing sexual harassment and assault is to ensure a safe and respectful environment, to hold perpetrators accountable, and to provide support and justice for victims.
Reports should include the details of the incident, such as the nature of harassment or assault, the date and time, location, parties involved, and any evidence or witnesses.
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