Employee Grievance Form

Purpose: This form is used by employees to formally report grievances, complaints, or workplace concerns to the Human Resources department for review and resolution. It helps maintain a positive and respectful workplace by allowing employees to express issues or conflicts appropriately and through the proper channel.

Employee Details

Full Name: {employeeName}

Employee ID: {employeeId}

Department: {department}

Position/Title: {position}

Contact Information: {contactInfo}

Date of Submission: {submissionDate}

Grievance Details

Type of Grievance: {grievanceType}

Date of Incident: {incidentDate}

Location of Incident: {incidentLocation}

People Involved:

{#peopleInvolved}

• {name} - {role}

{/peopleInvolved}

Description of the Issue

{grievanceDescription}

Attempts to Resolve

Have you attempted to resolve the issue? {attemptedResolution}

{#hasResolutionDetails}Resolution Attempt Details: {resolutionDetails}{/hasResolutionDetails}

Requested Action

{requestedAction}

Attachments

{#attachments}

• {fileName}: {fileDescription}

{/attachments}

HR Use Only

Received By: {receivedBy}

Date Received: {dateReceived}

Follow-up Actions:

{#followUpActions}

• {actionDate}: {actionDescription}

{/followUpActions}

Status: {caseStatus}

Resolution Date: {resolutionDate}

Notes:

{hrNotes}