Workplace Harassment & Retaliation Log PDF (Free Template)
Record workplace harassment or retaliation incidents in a private log you can bring to HR, legal aid, or the EEOC.
Published November 21, 2025
If you are experiencing harassment or retaliation at work, keeping a detailed log can be critical. This free PDF template lets you record dates, times, witnesses, and what happened in your own words so you have documentation when you are ready to report it.
When to use this
- You believe you are being harassed or discriminated against at work.
- You suspect you are being punished or retaliated against after reporting misconduct.
- A lawyer, union representative, or legal aid clinic has advised you to keep a written log.
How to do it (fast)
- Enter your name, job title, department, and employer information at the top of the form.
- For each incident, record the date, time, location, people involved, witnesses, and what happened.
- Note any impact on your work, pay, or health, and where you reported the incident (if you did).
- Download the PDF and store it securely so you can share it with HR, your attorney, or a government agency if needed.
Why this helps
- Gives you a clear, dated record of what has been happening over time.
- Helps HR, lawyers, or agencies understand the pattern—not just one incident.
- Pairs well with emails, texts, and performance documents if there is an investigation.
Related tools
- Workplace Harassment & Retaliation Log PDF tool
- Employee Disciplinary Action Report PDF
- Statement of Facts PDF tool
Not legal advice. Courts set their own rules. Keep your original records.