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`Case 2:24-cv-02237-TLP-atc Document 1-8 Filed 04/16/24
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`EEOC Form5(11/09)
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`Name(indicate Mr., Ms., Mrs.)
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`Mrs. Audrey K. Ragsdale
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`6491 CROFT OAKS CV
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`BARTLETT,TN 38134
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`(901) 262-1294
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`Namedis the Employer, Labor Organization, Employment Agency, Apprenticeship Committee, or State or Local Government Agency That I Believe Discriminated
`Against Meor Others. (Jfmore than two,list under PARTICULARSbelow.)
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`METHODIST NORTH HOSPITAL
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`3960 NEW COVINGTON PIKE
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`MEMPHIS, TN 38128
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`No. Employees, Members
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`Phone No.
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`201 - 500 Employees
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`(901) 516-5200
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`No. Employees, Members
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`Phone No.
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`City, State and ZIP Code
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`DISCRIMINATION BASED ON
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`DATE(S) DISCRIMINATION TOOK PLACE
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`Earliest
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`11/06/2021
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`Latest
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`12/01/2021
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`THE PARTICULARSARE(Ifadditional paperis needed, attach extra sheet(s)):
`I began my employmentwith the above name company on June 15, 2015, as a Medical Laboratory Technologist. On August 16, 2021, I was notified
`by my employerthat all employees were required to be fully vaccinated by November 1, 2021. I notified my employerthe vaccination conflicted
`with my sincerely held religious belief and requested a religious accommodation that was approved. On November6, 2021, Lab Director Jane
`Nichols placed me on two weekssuspension. On December1, 2021, I was terminated for not getting the COVID vaccination or agreeingto invasive
`testing. The employer wanted to continue to test me for COVID-19 invasively, which I believe should notoccur.I believe I have been discriminated
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` CHARGE OF DISCRIMINATION
`) Charge No(s):
` Statement and other information before completing this form.
` 490-2022-00294 This form is affected by the Privacy Act of 1974. See enclosed Privacy Act
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` and EEOC
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`Tennessee Human Rights Commission
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`State orlocal Agency, ifany
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`HomePhone
`YearofBirth
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`against because of myreligion, Christianity, in violation of Title VII of the Civil Rights Act of 1964, as amended.
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`I will advise
`I wantthis charge filed with both the EEOCandtheState or local Agency,if any.
`the agencies if I change my address or phone numberand I will cooperate fully with them in
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`the processing of my chargein accordancewiththeir procedures.
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`I swearoraffirm that I have read the above chargeandthatit is true to the best
`I declare underpenalty of perjury that the aboveis true and correct.
`of my knowledge, information andbelief.
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`SIGNATURE OF COMPLAINANT
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`Digitally Signed By: Mrs. Audrey K. Ragsdale
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`NOTARY— When necessaryfor State and Local Agency Requirements
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