Get the free EEO Counselor Intake Form - csosa

EEO COUNSELOR INTAKE FORM. DATE OF REQUEST: NAME:. Employee. Applicant. Job Title/Series/Grade: ...

How to fill out eeo counselor intake form

How to fill out eeo counselor intake form:

1. Start by providing your personal information, including your full name, address, phone number, and email address. This will help the counselor to contact you if needed.
2. Next, fill in your job title and the organization you work for. If you're not employed, provide your current status or occupation.
3. Indicate the date when the incident or discrimination occurred. Be as specific as possible and mention the time if applicable.
4. Describe the incident or discrimination in detail. Provide a clear and concise account of what happened, including any conversations or actions that took place. Use objective language and avoid personal opinions or assumptions.
5. State the individuals involved in the incident, including any witnesses if available. Provide their names, job titles, and any other relevant information that can help identify them.
6. Explain any steps you have taken so far to address the issue, such as reporting it to a supervisor or HR department. If no action has been taken, mention that as well.
7. Indicate the desired outcome or resolution you seek from filing the complaint. This could include corrective measures, disciplinary action, or changes in policies or procedures.
8. Finally, sign and date the form to acknowledge that the information provided is true and accurate to the best of your knowledge.

Who needs eeo counselor intake form:

1. Any individual who believes they have been subjected to discrimination or harassment based on race, color, religion, sex, national origin, age, disability, or genetic information may need to fill out an EEO counselor intake form.
2. Employees of federal agencies, contractors, or subcontractors who want to initiate the Equal Employment Opportunity (EEO) complaint process may be required to complete this form.
3. Individuals who are seeking employment with federal agencies or contractors may also need to fill out an EEO counselor intake form if they believe they have experienced discriminatory practices during the application or selection process.

It's worth noting that the specific requirements for filing an EEO complaint may vary depending on the organization or agency involved. It's recommended to consult the relevant policies and procedures or contact an EEO counselor for accurate and up-to-date information.

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