Division of People and Culture
Employee Relations (501) 686-5650
Discrimination or Discriminatory Harassment Report
NOTE:
All fields are required unless otherwise indicated. Please click
Save
at the bottom of each page to proceed to the next one. On the last page, click
Submit
to submit the report.
Reporter type
Your relationship to UAMS
Pick one...
Faculty member
Patient
Resident
Staff member
Student
Visitor
Other
Unknown
I'm making this report on behalf of someone else.
Yes
No
Which choices apply to the complaint? You may choose more than one.
Age (Over 40)
Color
Disability
Family Medical Leave Act (FMLA)
Gender
Gender identity
Genetic information
Marital or parental status
Military service/Veteran status
National origin
Pay equity
Pregnancy
Race
Retaliation
Sex
Sexual orientation
Information about the accused person
Relationship to UAMS
Pick one...
Faculty member
Patient
Resident
Staff member
Student
Visitor
Other
Unknown
Accused person's name (if you don't know it, enter
Unknown
).
Accused person’s description (if you don’t have a name, describe only the accused person here).
Click
Save
to save information about you and the accused person(s). On the next page, you will enter details about the incident.