SGMHA Informal Incident Form

SGMHA Informal Incident Form
This form is for minor infractions of the SGMHA Code of Conduct. Examples would include (but not limited to) disrespect that does not reach the level of harassment, abuse or bullying, online or in person, as well as conduct that is not up to par of SGMHA standards in agreeance with our Code of Conduct.

The complainant will not be notified of the outcome. A letter/statement will be submitted to the individual(s) complained of detailing the complaint and recommended steps to resolve, which further follow up. The complainant will not be identified in the case of an informal complaint.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Date of incident*

MonthDayYear
Date
Time of incident*

Hour Minutes

AM/PM Option
Location of incident:*
Name(s) of offending individual(s):*
Team incident is associated with:*
Any other parties aware of the incident?*

YesNoNot Sure
Please provide a clear, fact-based description of the actions or statements witnessed. Should you wish to provide additional information, some questions that may help prepare this report include: What was the nature of the incident? Were any steps taken to address the incident? What were the actions or statements regarding? Were children present?
Provide your detailed answer here.*
Should be Empty: