Ethics Reporting

If there is an immediate threat to someone’s safety, contact emergency services at 911 before submitting this form.

Shift Fillers is committed to conducting business with integrity, respect, accountability, and compliance with all applicable laws and company policies.

If you have witnessed, experienced, or become aware of conduct that you believe may violate our Code of Conduct, company policies, applicable laws, or ethical standards, we encourage you to report it.

We prohibit retaliation against anyone who, in good faith, raises a concern, reports suspected misconduct, or participates in an investigation.

Ethics Reporting (#5)

1. What type of Concern are you reporting? (Select all that apply)

Harassment or Discrimination

Retaliation

Safety or Workplace Concern

Wage, Payroll, or Timekeeping

Fraud, Financial Misconduct

Substance Abuse

Theft or misuse of Company/ Client property

Other

Explain Other

2. Where did the concern occur?

3. When did it occur?

4. Describe concern (Please include as much information as you can including who was involved and any witnesses)

First Name:

Last Name:

Phone:

Email:

Acknowledgment

By submitting this report, I understand that:

I am encouraged to provide truthful and accurate information to the best of my knowledge.

Reports may be reviewed by appropriate Shift Fillers personnel or other authorized parties for purposes of assessing and investigating the concern.

Shift Fillers prohibits retaliation against individuals who make a good-faith report or participate in an investigation.

I acknowledge the above and wish to submit my report.

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