HR Victims' Rights Policy

HR Victims' Rights Policy

Personal Information

Position Information

Employment History (most recent first)

Employer 1 — Company:

Title:   Dates Employed (From):   To:

Employer 2 — Company:

Title:   Dates Employed (From):   To:

Education

References (Professional)

Policy Purpose, Scope, and Definitions

Purpose: This policy sets forth the rights and procedural protections afforded to employees who are victims of domestic violence, sexual assault, stalking, or other violent crime. It establishes reporting options, interim safety measures, confidentiality rules, and non-retaliation protections in order to protect victim-employees and preserve workplace safety and operational integrity.

Scope: This policy applies to all employees, applicants, contractors, and volunteers. It governs employer response to reports or disclosures of victimization, requests for accommodations, leave, and investigatory processes when incidents affect workplace safety or job performance.

Definitions: For purposes of this policy, "victim" means an employee who alleges to have experienced domestic violence, sexual assault, stalking, or other violent crime. "Confidentiality" refers to the employer's obligation to limit information sharing as set forth below; confidentiality is subject to legal and safety exceptions.

Employee Rights and Protections

Right to Confidentiality: The employer will maintain information disclosed by a victim on a need-to-know basis. Personnel files, investigative records, and accommodation requests will be stored securely and access limited to those administering this policy, except where disclosure is required by law or necessary to protect safety.

Right to Interim Safety Measures: Upon receipt of a report, the employer will evaluate and, where appropriate, implement interim measures such as no-contact directives, temporary reassignment, modification of work schedule, remote work options, security escorts, or paid administrative leave to protect the safety of the victim and workplace.

Right to Reasonable Accommodations and Leave: Employees may request reasonable accommodations or job-protected leave as required by law or company policy for health, safety, court appearances, counseling, or relocation. Requests will be considered promptly and in accordance with applicable leave policies and anti-discrimination protections.

No-Retaliation: Retaliation against an individual for reporting victimization, requesting accommodations, participating in an investigation, or otherwise exercising rights under this policy is strictly prohibited and will result in disciplinary action up to and including termination.

Reporting Options and Investigation Process

Reporting Options: Employees may report to Human Resources, their supervisor or manager, or designated safety personnel. Reports may be made verbally or in writing. Employees retain the option to report incidents to law enforcement; the employer will respect that decision and assist as requested.

Investigation: Reports will be assessed promptly. When an investigation is warranted, it will be conducted objectively and impartially. The employer will take interim steps as necessary to ensure safety. Investigative outcomes will be communicated to the reporting party to the extent permitted by law and privacy considerations.

Confidentiality, Recordkeeping, and Limits

Confidentiality Limits: Complete confidentiality cannot be guaranteed when disclosure is necessary to protect safety, to comply with mandatory reporting obligations, to conduct an effective investigation, or to fulfill legal obligations. Information will otherwise be treated as private and maintained in secure records.

Recordkeeping: Records of reports, investigations, and accommodation requests will be retained in secure files separate from general personnel files and will be retained consistent with applicable retention policies and legal requirements.

Interim Measures and Accommodations

Available Interim Measures (check any requested):

Temporary reassignment of work location or shift    No-contact directive    Change in schedule    Remote work arrangement    Paid administrative leave

Incident Information (Optional)

Incident Date:

Legal Disclosures and Employee Acknowledgments

At-Will Employment: Employment with the company is at-will unless contrary to a written signed agreement. Nothing in this policy modifies the at-will relationship.

Equal Opportunity: The employer provides equal employment opportunity to all employees and applicants without regard to protected characteristics. Victim status will not be the basis for unlawful discrimination.

Acknowledgment of Policy Receipt: I have received, read, and understand the HR Victims' Rights Policy.

Authorization to Contact Previous Employers and Conduct Background Checks: I authorize the employer to contact prior employers and to conduct employment-related background checks as necessary to administer this policy and related safety or accommodation determinations.

Complaint Procedure and Remedies

Complaints under this policy should be made to Human Resources or a designated manager. The employer will investigate and will take corrective action where appropriate. Remedies may include interim measures, disciplinary action against policy violators, adjustments to work arrangements, and referral to supportive services.

Employee Certification

I certify that all information provided on this form is true and complete to the best of my knowledge. I understand the limits of confidentiality described above, my rights under this policy, and that retaliation against individuals who report or participate in investigations is strictly prohibited.

I authorize the employer to take reasonable steps to implement requested accommodations and interim measures and to obtain information necessary to evaluate reasonable accommodation requests and safety concerns.

Designated HR Contact

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