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Grievance Form Template

Streamline Your Complaint Management Process with Our Grievance Form

If your organization struggles to manage feedback or complaints, an effective grievance form can simplify the process. This grievance form template is designed for organizations looking to collect, manage, and resolve complaints efficiently, ensuring that concerns are addressed promptly and formally. With customizable fields, clear labeling for WCAG compliance, and easy integration into your existing workflows, you'll enhance transparency, improve communication, and build trust with your stakeholders, all while staying organized. Explore the live template now and start transforming your grievance handling.

Use this Template (FREE) Live Preview
Full name
Email address
Phone number
Preferred contact method
Email
Phone
Either
Department or unit (optional)
Relationship to the organization
Employee
Contractor
Student
Customer/Client
Visitor
Vendor/Supplier
Prefer not to say
Other
Please Specify:
Brief title or subject
Detailed description of the grievance
Type of grievance (select all that apply)
Please Specify:
Date of most recent incident
Is the issue ongoing?
Yes
No
Not sure
Location of the incident (site, area, or platform)
How often has this occurred?
One time
A few times
Many times
Ongoing
Not sure
People involved and any witnesses (names, roles, contact information if known)
Actions taken so far (e.g., reported to someone, discussions held, outcomes)
Describe any evidence or attachments (e.g., emails, messages, photos, documents)
What outcome would you like to see?
Which remedies would you consider acceptable?
Apology
Mediation or facilitated conversation
Policy review or clarification
Training or coaching
Change of assignment or schedule
Disciplinary action
Refund or compensation
Cease and desist/stop behavior
Other
Please Specify:
Priority level
Not urgent
Low
Moderate
High
Urgent
Are you comfortable being identified to the parties involved during the investigation?
Yes
No
Prefer to discuss
Do you consent to share this information with relevant investigators and management?
Yes
No
May we contact you for follow-up if needed?
Yes
No
Type your full name as your signature
Date
I confirm that the information provided is accurate to the best of my knowledge.
Yes
No
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Paper art illustration depicting a grievance form template for FormCreatorAI article

When to use this form

Use this form when someone needs to report unfair treatment, policy violations, or unresolved issues that require a formal review. Employees can document harassment, scheduling or pay errors, or safety problems; residents can log HOA disputes; customers can escalate service failures; and policyholders can describe claim handling concerns. Submitting details creates a clear record, sets timelines, and routes the case to the right team. If the matter involves workplace conduct, you may also open an HR Investigation form. For service issues, pair your submission with a Customer complaint form. Homeowners can attach proof gathered via an HOA Records request form. If your complaint involves an insurance claim, add an Insurance complaint form for faster follow-up.

Must Ask Grievance Questions

  1. What happened, including dates, times, location, and who was involved?

    Specifics allow accurate fact-finding and help verify patterns or conflicts. Clear details speed triage and reduce back-and-forth.

  2. Which policy, contract term, or expectation do you believe was violated?

    Naming the rule aligns your concern with company or community standards. It also directs reviewers to the correct process and remedies.

  3. What impact has this issue had on you, your work, or your environment?

    Impact shows urgency and risk, informing priority and remedies. Quantify effects on safety, time, costs, or well-being.

  4. What steps have you already taken to resolve the issue, and with whom?

    Prior actions reveal escalation history and prevent duplicate efforts. They also show whether informal resolution is possible or formal action is needed.

  5. What outcome are you requesting?

    Stating a clear remedy helps set expectations and speeds decisions. If the issue is personal offense without a policy breach, consider the Hurt feelings complaint form.

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