Disability, Discrimination, Retaliation Online Complaint Form

Instructions: Please complete this form to report any incidents of discrimination, harassment,
and/or retaliation. All complaints will be handled confidentially and are sent to
hr@reliablestaffing.com
(Provide as much detail as possible, including what happened, who was involved, and any supporting evidence.)
Do you require an interpreter to report this complaint?

Verbal Reporting
Verbal reports and complaints can be requested by leaving a message at 866-205-
2787. Please leave your name, phone number, and state you would like to make a
report or claim. An HR representative will reach out to take your formal verbal
statement.

Assistance for Non-English Speakers
If an employee requires assistance in reporting a complaint due to a language barrier,
an interpreter will be provided upon request.
Any individual assisting in translation or interpretation must maintain strict confidentiality
and is prohibited from discussing complaint details with anyone.

Investigation Process
All complaints will be promptly and thoroughly investigated.
Complainants of disability-based discrimination will receive written findings of the
investigation results, along with a general description of any remedial actions taken, if
applicable.
Appropriate remedial action will be taken to resolve complaints and to prevent future
incidents.

Non-Retaliation Assurance
Retaliation against any employee who reports discrimination, harassment, or retaliation,
or who participates in an investigation, is strictly prohibited.
Any retaliatory actions will result in disciplinary measures up to and including
termination.

Confidentiality Commitment
All complaints and investigations will be handled with the highest level of confidentiality
possible.
Information will only be shared on a need-to-know basis to ensure a fair and thorough
investigation.