NU - SPORT INTEGRITY - COMPLAINT FORM

Welcome to the secure and confidential intake form of NU Sport Federations Independent Third Party ("ITP"). This form allows you to make a complaint ("Complaint") to the ITP that will be processed in accordance with the NU Sport Federation Discipline and Complaints Policy ("The Policy").

Once you have submitted your form, a case file will be opened with the ITP and you will receive an email from the ITP within the following 72 Hours(Business Working Days).

The ITP will then perform an initial review of your Complaint and will determine appropriate next steps, in accordance with the Policy.

For all urgent situations requiring immediate intervention, contact:
Canada Suicide Prevention Service: 1-833-456-4566 (In Quebec: 1-866-277-3553)
Kids Help Phone: 1-800-668-6868

Confidentiality & Optional Identification
At the end of this form, you may choose whether or not to provide your name and contact information. Submitting a report anonymously is permitted. However, please be aware that if you do not provide identifying information and the details in your report are limited, NU Sport Federation and its Independent Third Party may be unable to fully assess, investigate, or take action on the matter.

If you choose to provide your name, NU Sport Federation and its Independent Third Party will keep your identity confidential and will not share it with your sport organization or the respondent unless disclosure is required to protect your safety or the safety of others, or is otherwise required by law. In such cases, every reasonable effort will be made to notify you in advance and obtain your consent where possible.

Your Full Name*

First NameLast Name

Your Email*

This will be primary way to reach you. Only complaints with a valid email address will be processed

Your Phone Number

This will be a secondary way to reach you if needed

Your Gender

Are you a Minor

Yes*No

Your Role

*If yes, you may appoint a representative such as a parent or guardian to act for you during the complaint process. The contact information for the representative should be provided below.

Name of Person Impacted*

Name of the individual on behalf of whom was Impacted. If no person was impacted, please put N/A in field.

Relationship with Person Impacted

What is your relationship with this person? Ex) parent, spouse..

Impacted Name Community*

Impacted Name Sport*

Impacted Age Bracket

Provide the age bracket of the impacted person

Name of Person who is Accused*

The person you are making the complaint about

Are they a Minor

Yes**No

Contact Information (if known)

Provide an email or phone number if known.

**If yes, they may appoint a representative such as a parent or guardian to act for you during the complaint process. The contact information for the representative should be provided below.

Date of Incident

If relevant, please provide the date of incident

Summary of the Incident*

Please explain what happened. Be detailed as you can.

Has the incident described been ongoing?

Yes, this has happened more than once.No, this is the first time this has happened.

Supporting Documents

Upload everything that supports or is relevant to your complaint that you currently have available. This material can include details about the events before, during or after the incident, photographs, texts, emails, witness statements, etc. You will be able to upload multiple documents

Have you reported this to your sport?

Do you want to proceed anonymously?*

The ITP is required to know your identity but will not share your identity if you wish to proceed anonymously. If you elect not to proceed anonymously, your name will appear on documentation issued throughout the proceeding. If you elect to proceed anonymously, your name will not be present in any of the issued documents shared with the Respondent. Please note that in some circumstances a Respondent is able to guess the identity of an anonymous Complainant. In which case, the ITP will never confirm or deny their suspicion.

Witness(es)

If anyone witnessed the incident(s) involved, please provide details regarding their involvement as well as their contact information below.

Witness #1 - Name

Role / Position

Email

example@example.com

Phone Number

Please enter a valid phone number.

Witness #2 - Name

Role / Position

Email

example@example.com

Phone Number

Please enter a valid phone number.

Consent and Agreement

Your Complaint will be submitted to the ITP and will be administered pursuant to the NU Sport Federation Policies, which can be found here: NU Sport Federation Policies

The ITP may forward a copy of this form and accompanying documents to the Accused for their review and response to the allegations contained therein;
You agree to participate in a Discipline Hearing and/or in a follow up interview, if required; and
To the best of your knowledge, the information submitted in your Complaint is complete and accurate

By selecting "I Agree" and by submitting your Complaint, you confirm and agree.