Employee Relations Complaint Form

Click here for an at-a-glance description of the Employee Relations investigations process.

File a Complaint Alleging Discrimination or Retaliation Related to Disability, Disability Requests

Submit an Online Employee Relations Complaint

You must complete all applicable sections before submitting. Employee Relations can assist you with completing this form.

Complainant's Information

Do you have UFID?

Yes, I have a UFID.No, I do not have a UFID.

UFID

If you receive an error upon submission please obtain your correct UFID. UFID Look Up

First Name 

Last Name

Preferred Phone

Preferred Email

Preferred Method of Contact

Please select... Email Phone

May we leave messages at this phone number?

Please select... Yes No

Respondent's Information

The respondent is the person or persons against whom you are submitting a complaint.

Respondent First Name

Respondent Last Name

Relationship to the Complainant

Please select... Supervisor Colleague Direct Report Faculty Other

Other Working Relationship

Add a second respondent

Respondent First Name

Respondent Last Name

Relationship to the Complainant

Please select... Supervisor Colleague Direct Report Faculty Other

Other Working Relationship

Add a third respondent

Respondent First Name

Respondent Last Name

Relationship to the Complainant

Please select... Supervisor Colleague Direct Report Faculty Other

Other Working Relationship

Basis of Complaint

Basis of Complaint

Explain your situation with as much detail as you can. Include the names of the people who you believe are engaged in misconduct.  Be sure to include date(s) of the incident(s), specific location(s), and any supporting details. Identify any University or departmental policies, regulations, or laws you believe have been violated. Please describe the specific way(s) in which you believe you have been harmed as a result of the circumstances reported above and explain how you believe Employee Relations can resolve the situation to your satisfaction (i.e., describe what you would like to see done)

Witnesses

Identify by name and job title or position any witnesses who have personal knowledge of the incidents or conduct you describe.

First Name 

Last Name

Job Title or Position

Add a second witness

First Name 

Last Name

Job Title or Position

Add a third witness

First Name 

Last Name

Job Title or Position

Description of Desired Resolutions/Outcomes

Please provide several possible solutions that you believe would resolve the situation you have described.

Attachments

To best assess your complaint, attach below all relevant documentation (e.g., emails, letters, etc.).

Document

By submitting this complaint below, I certify that the information given in this complaint is true and correct to the best of my knowledge or belief. I understand I will be contacted by Human Resources to discuss my concerns. Depending on the current volume of complaints, contact time may vary.