The Peer Company Grievance Form

Name of Complaintant

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

example@example.com

Contact Number

Please enter a valid phone number.

It is the policy of The Peer Company to maintain a harmonious and anti-racist workplace environment. The Peer Company encourages its employees to express concerns about work-related issues, including workplace communication, discrimination, interpersonal conflict, and other working conditions.

This grievance form is for individuals to complete if they have any concerns to voice to the The Peer Company management team. This electronic form will automatically be submitted to the People & Culture Director. If you would like to request a paper form, please email peopleculture@mhaoforegon.org, call our office at (503) 922-2377, or you can request a form via mail to the following address:

The Peer Company
Attention: People & Culture
2740 SE Powell Suite 3
Portland, OR 97202

Describe in detail the nature of your grievance.

Give the name of the person you first reported the grievance to.

First NameLast Name

Describe what measures you expect to be taken to resolve your grievance.

Signature of the Complainant

Date

The following process shall be used in reviewing and resolving grievances:

Step 1: The person with the grievance shall communicate verbally and in writing with the MHAAO Program Manager for the program about which the grievance is being filed. The Program Manager shall review the grievance and respond in writing within 7 working days a proposed resolution. The HR Director and MHAAO Executive Director shall be notified of the grievance. If the grievance involves any member of management, then the HR Director shall receive the grievance.

Step 2: If unresolved at Step 1, the grievance and proposed resolution shall be forwarded to the MHAAO Program Director for the affected program within 7 working days. The Program Director shall review the grievance and respond in writing within 7 working days, a proposed resolution.

Step 3: If unresolved at Step 2, the grievance, and all previously proposed resolutions shall be forwarded to the HR Director and Executive Director within 7 working days. The HR Director and Executive Director will review the grievance, and respond in writing within 7 working days a proposed resolution.

Step 4: If unresolved in Step 3, the person with the grievance must request an Administrative Review by the MHAAO Board of Directors within 15 working days of the Executive Director's decision.

A designated Administrative Review Committee of the MHAAO Board of Directors will review the grievance, all previously proposed resolutions, and issue a final decision in writing within seven working days of receiving the grievance.

Grievance Form

Grievance and Administrative Review Process