Forms → Staff → Bullying → Discrimination, Harassment, and Workplace Bully Complaint
Form number: 230-39
Audience: MCPS Staff
Last revised: February 2023
Employees are encouraged to use the electronic or PDF versions of this form when making a complaint of discrimination, harassment, or workplace bullying under MCPS Regulations ACA-RA: Nondiscrimination, Equity, and Cultural Proficiency and/or ACH-RA: Workplace Bullying. The electronic version of this form is found online: https://ww2.montgomeryschoolsmd.org/departments/forms/detail.aspx. Forms can be emailed to DCI@mcpsmd.org.
Employees should complete all sections of this form. Be specific as possible when discussing the incident(s). Include the date(s), description(s), the name(s) of the person(s) involved, and the name(s) of those who may have witnessed the incident(s). In addition to this form, you are permitted to attach additional materials, which may assist in the investigation process.
Questions about complaints of discrimination, harassment, or workplace bullying may be directed to the Department of Compliance and Investigations (DCI) at 240-740-2888.
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