Workplace Bullying & Harassment Report Webform

Upon submission of this form a copy of the information will be forwarded to Safety & Risk Services for review and follow up.

Employee Information

The information received from the Workplace Bullying and Harassment Report form is collected under the general authority of the University Act (R.S.B.C. 1979, c.419), the Occupational Health and Safety Regulation (B.C. Reg. 296/97) and SFU GP 17 University Occupational Health and Safety Policy.  Form information is directly related to capturing the necessary information required for the University to address workplace bullying and harassment complaints. The information will be used to determine whether an investigation into a complaint is required and to initiate an investigation, when necessary.   If you have any questions about the collection and use of this information please contact TJ Aujla, Director – Occupational Health and Trades Safety unit in Safety & Risk Services - Environmental Health & Research Safety, 778-782-4978.

Pursuant to Section 27(1) of the Freedom of Information and Protection of Privacy Act, I 

agree to authorize SFU to contact the persons or organizations listed below for the purposes of obtaining information pertaining to the complaint of workplace bullying and harassment. These persons or organizations are authorized to disclose such information.
I understand that failure to give my authorization will prevent the initiation of an investigation into and subsequent resolution of my complaint.

Supervisor Information

Alleged Bully or Harasser Information

Witness Information

Bully or Harassment Details

Is the bullying or harassment based on

Response Details

Have you indicated to the alleged bully or harasser(s) that you don't like their behaviour or want it to stop?
Have you reported your complaint to any of the following?

If you would rather use a printable hardcopy of this form, click here.