Forms

We invite you to self-identify whether you have a disability or are a covered veteran as defined on the Voluntary Self ID Form (PDF) or accessed through Workday. To update your personnel record, please go to Workday (PennKey required) or contact your human resources contact or department chair.

Self-identification of a disability or veteran status is strictly voluntary. You may self-identify at any time during your employment with the University. Completed self-identification forms are maintained in files separate from that individual's personnel file and are held in strict confidence, except that:

• Administrators, managers, or supervisors may be informed of any work restrictions or reasonable accommodations;
• First aid or safety personnel may be informed, to the extent necessary, to administer any emergency treatment; and
• Government officials may review the forms in conjunction with an investigation or audit of the University's compliance with relevant federal, state or local law.  

Voluntary Self ID Form (PDF) 
Workday* (PennKey required.)

Individuals may report their concerns about having been treated in a biased or discriminatory manner by completing a Bias Incident Reporting form. The report will be directed to the appropriate office for follow up and/or support. In addition, the University has resource offices available to respond to complaints and concerns, including the Office of Equal Opportunity Programs, the Office of Community Standards and Accountability, the Office of Staff and Labor Relations, in the Division of Human Resources, and the Office of the Vice Provost for Faculty.

If you have questions or need a reasonable accommodation to complete the form, please contact the Office of Equal Opportunity Programs and call (215) 898-6993.

Bias Reporting Incident Form

A formal complaint under this policy must be made in writing, signed by the Complainant and submitted within 30 days after the alleged violation, if reasonably possible. The Complaint of Discrimination or Harassment form (two formats below), which are available on the web or in the Office of Equal Opportunity Programs, must include a detailed statement of the known facts out of which the complaint arises, a request for specific relief, and the names and contact information for any witnesses to the incidents mentioned in the complaint. The information you provide on this form will be maintained confidentially to the fullest extent possible.

The form is a non-interactive PDF form. Please print out the form and submit the completed form and other necessary documents to the Office of Equal Opportunity Programs. If you have questions or need a reasonable accommodation to complete the form, please contact our office at oeop@pobox.upenn.edu or call (215) 898-6993.

Complaint Form (Harassment/Discrimination) (PDF) 
Complaint Form (Harassment/Discrimination) (Word)

Reasonable Accommodation Request Forms

To request a reasonable accommodation, please complete the Reasonable Accommodation Request Form and have your medical provider complete the Reasonable Accommodation Medical Authorization Request Form. Have all forms completed, signed and submitted to the  Office of Equal Opportunity Programs either by email oeop@pobox.upenn.edu or fax (215) 746-7088. The medical accommodation form must be completed in order to process the employee's request (except for pregnancy or childbirth related accommodations).

Reasonable Accommodation Request Form (PDF)  
Reasonable Accommodation Medical Authorization Form (PDF / for medical provider)  
 

Parking Accommodations (Penn Access Transit)

Penn Access Transit (PAT) Request Form is used to register Faculty and Staff for the use of the service. PAT service is transportation service available for faculty, staff and students with mobility and vision disabilities. You must have authorization from our office or Disability Services (for students). Faculty and staff members must complete the form, print, sign and submit it to OEOP along with any needed medical documentation to register for this service.

Penn Access Transit Request Form (PDF) 
Penn Access Transit Medical Authorization Form (PDF)