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Page 1 of 7 Utah Antidiscrimination Labor Division Employment Discrimination 160 East 300 South 3rd Floor PO Box 146630 Salt Lake City UT 84114 6630 Phone 801 530 6801 Fax 801 530 7609 Email discrimination utah. gov INTAKE QUESTIONNAIRE FOH LOR Intake Waiver LOH 180 ADA Do Not Mark in this Space 5/15 THIS FORM DOES NOT REPRESENT A CHARGE OF DISCRIMINATION WITH THE DIVISION. In order to file a Charge with the Division you must complete and return this form. The Division will use the...
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How to fill out intake questionnaire employment discrimination

Answers:
01
To fill out an intake questionnaire for employment discrimination, you need to gather all relevant information and be prepared to provide accurate details. Start by reading the questionnaire thoroughly to understand the requirements and questions asked.
02
Begin by providing your personal information, such as your full name, address, phone number, and email address. This information is essential for the organization or agency handling your case to contact you.
03
Next, you may be asked to provide information about the company or organization you believe discriminated against you. Include details such as the name, address, and contact information of the employer. If applicable, provide any job-related information, such as your job title, department, and supervisor's name.
04
The questionnaire may ask you to specify the type of discrimination you experienced. This could include discrimination based on race, gender, age, disability, religion, or any other protected characteristic. Be clear and concise in your response, providing specific instances or examples that support your claim.
05
When describing the discrimination you faced, provide as much detail as possible. Include dates, times, and locations of the incidents. Describe the actions or statements made by the individuals involved, including any witnesses who can support your claim.
06
The questionnaire may ask about any previous complaints or legal actions related to your case. If applicable, provide information about previous complaints filed, their outcomes, and any legal actions taken in relation to employment discrimination.
07
It may be necessary to provide supporting documentation, such as emails, letters, or other evidence that substantiates your claim. These documents can help strengthen your case and provide additional context.
08
Finally, review your answers to ensure they are accurate and complete. Check for grammar or spelling mistakes, as these can impact the clarity of your responses. If possible, have someone else review your questionnaire before submitting it to ensure it is clear and concise.
Who needs an intake questionnaire for employment discrimination?
01
Employees who believe they have faced employment discrimination need to fill out an intake questionnaire. This includes individuals who have been subjected to unfair treatment or negative actions based on their protected characteristics, such as race, gender, age, disability, religion, or other grounds.
02
The intake questionnaire is typically required by organizations or agencies responsible for investigating and addressing employment discrimination claims. These may include government entities, human rights commissions, labor boards, or legal aid organizations. The questionnaire helps these entities gather relevant information to assess the validity of the discrimination claim and determine the appropriate next steps in the process.
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What is intake questionnaire employment discrimination?
The intake questionnaire employment discrimination is a form used to gather information about potential cases of workplace discrimination.
Who is required to file intake questionnaire employment discrimination?
Employees who believe they have been discriminated against or witnesses to discrimination may be required to file an intake questionnaire employment discrimination.
How to fill out intake questionnaire employment discrimination?
The intake questionnaire can typically be filled out online or submitted in person at the relevant employment discrimination agency.
What is the purpose of intake questionnaire employment discrimination?
The purpose of the intake questionnaire is to help determine whether there is a basis for further investigation into potential employment discrimination claims.
What information must be reported on intake questionnaire employment discrimination?
The questionnaire will typically require information such as details of the alleged discrimination, dates, names of witnesses, and any supporting documentation.
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