Appendix B-Form for Reporting Serious Misconduct

Reporting Serious Misconduct. This form should be completed by anyone aware of serious misconduct under the Whistleblowing Policy and should be forwarded to the appropriate individual as outlined in Section 3.3 of the Whistleblowing Policy.













TO BE COMPLETED BY INDIVIDUAL RAISING CONCERN

I hereby declare that I am raising this concern in good faith and have reasonable grounds to believe the information above is accurate and true.


(Staff and “others” making a report under this policy are encouraged to provide their name in confidence, which permits for follow-up questions and clarification if necessary. Investigation may not be possible unless the source of the information is identifiable. The Designate may investigate a report made on an anonymous basis and will determine whether to do so in light of all of the circumstances, including the seriousness of the issue raised, the credibility of the concern and the likelihood of confirming the allegation from other sources).


The above information is collected in accordance with the Personal Information Protection & Electronic Document Act. It is collected for purposes set out in the Whistleblowing policy.

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