Confidential Request for UNAC Representation: Ambulatory Svcs, MOBs, ER
Purpose for Contact
I have a question.
I want to file a grievance.
I may be in trouble with my manager.
I have received corrective action.
Name, Position, Floats (if any)
Date of Hire
Your Department Name and Work Location
Your Normal Work Days and Hours (skeleton)
Your PERSONAL Email (must be non Kaiser)
Your Cell Phone
Supervisor's Name (DA or ADA)
Witnesses / Accusers / Others Involved (if any)
Please Provide a Detailed Summary of Situation or Your Questions.
Contract Violations (if known)
Should be Empty: