Discrimination, Harassment, Or Retaliation Complaint Form

Use a DISCRIMINATION, HARASSMENT, OR RETALIATION COMPLAINT FORM template to make your document workflow more streamlined.

What this complaint form does

A Discrimination, Harassment, Or Retaliation Complaint Form records a person’s report of workplace discrimination, harassment, or retaliation for review by an employer, agency, or other authorized recipient. It generally captures the complainant’s identity, contact information, employment details, incident dates, locations, involved people, factual description, witnesses, requested resolution, and signature. The form is not itself a legal finding or a substitute for agency-specific filing requirements. Uploading it to signNow lets an authorized sender place fields, request signatures, and preserve a completion record under ESIGN and applicable state law.

How this complaint form works

A clear digital workflow moves the Discrimination, Harassment, Or Retaliation Complaint Form from preparation through signed record storage.

Upload: Upload the complaint form
Check fields: Review detected fields
Assign recipients: Add authorized recipients
Complete: Collect signatures and preserve records

Structured intake

Capture the complainant’s name, contact details, employment information, and incident narrative in one controlled document for review.

Field detection

Auto-detect fillable areas after upload, then place text, date, initials, and signature fields where the complaint requires completion.

Recipient routing

Send the form to authorized recipients in a defined sequence, reducing missing acknowledgments and unclear handoffs during review.

Audit trail

Record signer actions, timestamps, and document history so reviewers can trace how the completed complaint was handled.

Protected access

Use role-based access and encryption controls to limit exposure of sensitive allegations and personal information during processing.

Record storage

Store the completed complaint and its audit record together, supporting retrieval when an internal investigation or agency response requires documentation.

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Open the signNow web app, upload the Discrimination, Harassment, Or Retaliation Complaint Form, and review automatically detected fields before adding any missing response or signature fields.
Use the signNow mobile app when an authorized recipient must review or sign the complaint from an iOS or Android device away from a workstation.
Use kiosk mode for supervised completion at an authorized office location, ensuring the next person cannot access the previous complainant’s information.
Generate a shareable signing link when the approved recipient needs controlled access without receiving a separate email invitation.

Authenticate signer:

Record the authentication method used by each complaint signer.

Timestamp actions:

Capture the exact time and date for each action.

Track document history:

Preserve document changes through a tamper-evident history.

Seal completion:

Associate the completed complaint with its signing certificate.

Log recipient events:

Record recipient access, viewing, signing, and delegation events.

Export evidence:

Retrieve or export the audit trail with the completed complaint.

Security for complaint records

Data in transit:

TLS 1.2/1.3 encryption

Stored data:

AES-256 encryption at rest

Security certification:

SOC 2 Type II certified

Information security:

ISO 27001 certified

Health information:

HIPAA compliance with BAA

Electronic signatures:

ESIGN and UETA compliant

Best practices for complaint handling

Careful field completion, restricted access, documented consent, and complete audit evidence help preserve the complaint’s accuracy and usability.

Preserve the original incident narrative

Use the form’s incident-date, location, involved-person, witness, and narrative fields consistently. Ask the complainant to distinguish observed facts from conclusions, attach supporting records separately, and avoid editing their account after signature without documenting the change.

Restrict access before sending

Limit the sending list to the assigned investigator, authorized HR or compliance personnel, and required signers. Apply role-based access so allegations, contact details, and attachments are not broadly visible inside the organization.

Match authentication to sensitivity

Configure signer authentication appropriate to the complaint’s sensitivity and record the selected method. For consumer-facing electronic records, provide the ESIGN consent disclosure and confirm the signer can access and retain the electronic record.

Archive the complete evidence package

Export the completed complaint and audit trail together after signing. Apply the retention rule for the underlying record, document any litigation hold, and verify state-law requirements before scheduled deletion.

Retention rules for related records

Choose the retention period based on the complaint’s underlying record category, applicable federal rule, state law, and any litigation hold.

Three years: tax-related records

IRS retention rules apply only when the complaint record is also a tax record; IRC §6501(a) generally provides three years.

Six years: HIPAA records

HIPAA-covered complaint records require six years from creation or last effective date under 45 CFR §164.530(j).

Five years: OSHA injury records

OSHA injury records require five years following the year under 29 CFR §1904.33 when the complaint includes covered injury documentation.

Thirty years: exposure records

OSHA exposure records require 30 years under 29 CFR §1910.1020 when the complaint includes covered exposure information.

Three years: FLSA payroll records

Employment records connected to the complaint may require three years under 29 CFR §516.5 when they are covered FLSA payroll records.

Risks from incomplete complaint records

Missing incident details

Incomplete facts

Exposed allegations

Unauthorized disclosure

Weak e-record consent

Unclear consent

Incomplete audit trail

Missing evidence

Troubleshooting complaint form workflows

Resolve specific upload, authentication, compliance, routing, and record-retention questions before distributing a completed complaint.

Upload the original PDF or document again and confirm it is not password-protected. signNow’s field-detection workflow can then identify fillable areas; manually add fields when the source file contains only scanned images.

Business includes legally binding eSignatures, templates, and audit trails at $8/user/month when billed annually. For sensitive allegations, configure signer authentication and confirm your organization’s access policy before sending.

Use signNow’s signer-authentication options, including SMS or stronger methods available to your plan, and restrict recipients to authorized reviewers. HIPAA compliance requires a BAA when protected health information is involved.

The form may be electronically signed when the recipient consents and applicable law permits it. ESIGN and UETA recognize qualifying electronic signatures, but agency rules or state procedures may impose additional requirements.

Business Premium includes bulk send, but a discrimination or retaliation complaint usually contains individualized allegations. Send each completed form only to authorized recipients rather than using a shared batch.

Export the completed document and audit trail from signNow, then apply the retention rule for the underlying matter. Federal law does not provide one universal period for every complaint record; preserve litigation holds separately.

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