Inclusion Feedback Slip

Employee Information

Employee Name:	[Employee's Name]
Employee ID:	[Employee ID]
Department:	[Department]
Date:	[Date of Submission]

Feedback Type:

• Compliment

• Suggestion

• Concern

• Other (Please Specify): _______________

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Inclusion Topic

• Recruitment and Hiring Process

• Onboarding Experience

• Team Collaboration

• Training and Development

• Company Culture

• Other (Please Specify): _______________

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Feedback Details

Please provide specific details of your feedback in the space below:

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Desired Outcome (Optional)

Please describe any desired outcomes or changes you would like to see as a result of your feedback:

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Confidentiality Preferences

• I would like to keep this feedback anonymous.

• I am comfortable with my identity being shared for follow-up.

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Contact Information for Follow-Up (Optional)

Field	Details
Phone Number:	[Your Phone Number]
Email Address:	[Your Email Address]

Thank you for your feedback. The Human Resources Department is committed to fostering an inclusive work environment. Your input is valuable to us, and we will review it promptly.

Please return this form to the Human Resources Department via [submission method: email/hand-delivery/internal system].

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For HR Use Only:

Field	Details
Received By:	[HR Staff Name]
Date Received:	[Date]
Action Taken:	[Action Taken]
Follow-Up Date:	[Follow-Up Date]

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