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BASIS OF YOUR COMPLAINT: What is the reason for your complaint (Please check all applicable items.) Age Ancestry Color Disability Gender Expression Gender Identity Genetic Information Harassment Marital Status National Origin Political Affiliation Pregnancy Race/Ethnicity Religion Reprisal/Retaliation Sex Sexual Harassment Sexual Misconduct Sexual Orientation Veteran Status Other, please state: Title IX If you checked color, religion or national origin, please specify: If you checked genetic information, how did the Respondent obtain the genetic information: What type of genetic information is involved: genetic testing family medical history Page 1 of 4 genetic services 3..
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