Employee Statement Form
This form is designed for employees to privately document incidents or express concerns they wish to bring to the attention of management in a confidential manner. All submissions are sent directly to VE management and are not shared with other leadership, including the supervisor team.
First & Last Name
*
Anonymous statements are not permitted for Employee Statements. Please input your first & last name.
Date
*
-
Month
-
Day
Year
Today's Date or Date of Incident
Statement
Please provide a factual statement that includes all pertinent information (who, what, where, when) regarding incidents or concerns. Please rely on details and not feelings. All information shared in this form will be kept strictly confidential and will not be disclosed to any parties without prior consent.
Please provide your statement below. Please be as detailed as possible.
*
Signature
By signing this document, you are agreeing that the information provided is accurate to the best of your ability.
Submit
Should be Empty: