Get Tn Intake/referral Form

This guide provides a detailed step-by-step approach to filling out the TN Intake/Referral Form online. By following these instructions, users can ensure that they complete the form accurately and efficiently.

Follow the steps to successfully complete the form.

1. Click the ‘Get Form’ button to obtain the TN Intake/Referral Form and open it in your online editor.
2. Fill in your name as the complainant or person reporting the event in the designated field. This is important as it identifies you as the individual raising the concern.
3. Provide the telephone numbers where you can be reached. Include your work, home, and mobile numbers. If your home telephone number is unlisted, indicate this by choosing 'yes' or 'no' in the appropriate checkbox.
4. Specify the name of the agency and division involved in your complaint. This helps to direct your concerns to the correct authority.
5. List the name(s) of the person or people who allegedly discriminated against you or harassed you. Include their full names to ensure clarity.
6. Describe your relationship to the individual(s) accused, for example, if they are your direct supervisor or coworker.
7. Enter the dates of the earliest and latest occurrences of the events relevant to your complaint. This timeline is essential for the investigation process.
8. Clearly explain how you were discriminated against, using specific examples such as disciplinary action or creating a hostile environment. Include as much detail as possible.
9. Provide a thorough explanation of what happened, detailing who was involved, where the incidents occurred, and any other important information. You may attach additional pages if necessary.
10. Articulate why you believe these events occurred. This will help to establish a context for your complaint.
11. Describe how others were treated differently than you, and if applicable, select 'yes' or 'no' for whether other employees were treated better in similar circumstances. If yes, provide their names and details.
12. List any individuals who may have additional information to support your complaint, including their potential contributions.
13. Speculate on what explanation the agency or accused may provide regarding the treatment you received.
14. Identify any additional information you think is relevant to the matter, including documentary evidence like emails or recordings.
15. Express what you would like to happen as a result of filing this complaint.
16. If you have shared this matter with others, list their names and relationships (e.g., coworker, family member).
17. Sign the form as the complainant and date it. If someone else completed the form on your behalf, they should provide their details in the specified sections.
18. Finally, submit the completed form to the designated address, ensuring that it reaches the appropriate department.

Complete your TN Intake/Referral Form online today to ensure your voice is heard.