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5.15 · Safety in the Workplace

Acknowledgment of Harassment, Discrimination, and Retaliation Policies

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Acknowledgment of Receipt of Policies on Prohibited Harassment, Discrimination, and Retaliation

I acknowledge that I have received a copy of the Company's Harassment, Discrimination, and Retaliation policies, including the procedure for reporting an incident or filing a complaint. I understand and agree that it is my responsibility to read and familiarize myself with these policies and to abide by them.

I understand that the Company is committed to providing a work environment free from harassment, discrimination, and retaliation, consistent with applicable federal law and the Florida Civil Rights Act of 1992. My signature below confirms that I understand I must conform to and abide by the rules and requirements described in these policies.

Print name: ______________________________________

Credentials (RBT, BCaBA, BCBA, etc.): ________________________

Employee signature: ______________________________________

Initials: ________________________

Date: ______________________________________

Must be signed and returned to [Company] Human Resources.