Human Capital

Special instructions USGS employees deployed to support emergency, disaster, or incident response operations

Word version

USGS employees supporting these unique operations are typically not in an office environment and may have limited access to the USGS intranet. If you are supporting special operations and experience or witness harassment there is some basic information we need you to collect about the situation.

If you can provide more detailed information, like what is collected on the “Report of Alleged Harassment Intake Form” found on the USGS Anti-Harassment Program website, please do so. However, we understand that may not be possible. If it will not jeopardize your safety or security, please collect the following information and follow the protocols for notifying the appropriate officials, including the USGS lead for the operation.

Report of Alleged Harassment – Information to Collect

  1. Who is filing the report?
    • Name (First/Last):
    • Organization:
    • Contact Information (Phone/Email):
  2. Who is involved?
    • Alleged Victim(s) (complete if different from person filing the report)
      1. Name (First/Last):
      2. Organization:
      3. Contact Information (Phone/Email):
    • Alleged Harasser(s)
      1. Name (First/Last):
      2. Organization:
      3. Contact Information (Phone/Email):
  3. When and where did the incident(s) take place? (Date(s)/Facility/City/State)
  4. Is there an immediate safety or security risk? (Yes/No)
  5. What happened? (Briefly describe the alleged harassing behavior/conduct)
  6. Were there any witnesses? (Name/Organization of each witness)
  7. Has the Incident Commander been notified? (Yes/No)
  8. Has the USGS Team Lead for the incident been notified? (Yes/No)
  9. Has the USGS Emergency Management Coordinator been notified? (Yes/No)



Jo-Ann Dominique

Anti-Harassment Program Manager
Phone: 703-648-7452