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- Fill in the 'Location of Incident' along with your personal details, including your address, name, date of birth, and contact numbers. Ensure accuracy for effective communication.
- Provide details about the person assisting you, if applicable, along with their contact information.
- In the section regarding the employee complained about, include any known identifiers such as name or badge number.
- Answer the questions regarding safety and language assistance honestly. If applicable, provide additional details in the space provided.
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