Workplace harassment complaint form

This is a generic Unifor Harassment Form and should only be used by locals who do not have their own pre-printed forms.

Harassment Forms must be completed and signed by elected union representatives, not by individual members.
Enter your email*
Enter Email Confirm Email
Local*
Name of applicant*
Employer*
Name(s) of alleged harasser(s)*
Applicant's description of what happened

Save and Continue Later

RESOLUTION
Resolution*
If the complaint has not been resolved informally, this form must go to either the unit chairperson so that she or he can arrange for an investigation, or to the person already designated by the union to investigate workplace harassment complaints.
Workplace harassment policy?
Does your collective agreement include a joint workplace harassment policy?
If YES, follow the procedure outlined in your collective agreement and refer to the Unifor Pocket Guide on Investigating and Resolving Workplace Harassment Policy for guidance.

If NO, follow the procedure outlined in the Unifor Pocket Guide on Investigating and Resolving Workplace Harassment Policy in conjunction with your collective agreement.
Signature of employer representative
Date of harassment*
DD dash MM dash YYYY
Email
This field is for validation purposes and should be left unchanged.

Save and Continue Later

IS IT HARASSMENT?