RTO – intake form

Language:

English

Please select the language of your choice in the upper right corner. SVP, sélectionner la langue de votre choix dans le coin droit supérieur de la page.

Name

Email (personal)

Phone number

City

Please select

Group

Department or agency

I am flagging a workplace issue on:

health & safety

accommodation issue

telework agreement related concern

other

I need assistance with:

If you don't need assistance leave this question blank.

Filing a health & safety complaint

Addressing an accommodation request denial

Addressing a violation of the terms of my current telework agreement and/or the denial of my telework request

Please provide a description of your issue or question: