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Human Resources

Forms

formTo report complaints of Discrimination, Harassment and Retaliation, please use the appropriate forms below:

For Students:

Discrimination, Harassment & Retaliation Complaint Form – Student

For Employees or Third Party:

Discrimination, Harassment & Retaliation Complaint Form – Employee & Third Party

Mentors:

If a mentor will be present for the meetings or any proceedings, please complete the Mentor Request form and submit it two (2) working days before the meeting to Dr. Geri Abracosa.  The Mentor Guide will assist the Mentor in understanding their role in this process.

Mentor Request Title IX Process

Mentor Guide to the Title IX Process

 

After completing the form, please sign it and send it to:

Dr. Geri Abracosa, SPHR
Director, Emp-loyee Relations
Office of Human Resources
Western University of Health Sciences
309 E. Second Street
Pomona, CA 91766
Phone: (909) 469-5372
Fax: (909) 469-5489
e-mail: gabracosa@westernu.edu