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Were you recently terminated, quit your job, or are you still employed?

When did this happen?(Answer the previous question first)

How long did you work there?(Answer the previous questions first)

What type of sexual harassment did you experience?(Answer the previous questions first)

How often did the harassment occur?(Answer the previous questions first)

When did the most recent harassment incident occur?(Answer the previous questions first)

Were there any witnesses to the harassment?(Answer the previous questions first)

Do you have any evidence of the harassment?(Answer the previous questions first)

Did you report the harassment to your employer, HR, or a supervisor?(Answer the previous questions first)

What was your employment status?(Answer the previous questions first)

What was your hourly wage?(Answer the previous questions first)

$per hour

Roughly how many employees does the company have?(Answer the previous questions first)

Please tell us what happened in detail:(Answer the previous questions first)

What is the name of your employer/company?(Complete the previous questions first)

Contact Information(Complete the previous questions first)