Free form template · Word

Open Door Request Form

An open door request form lets an employee ask for a private meeting with a senior leader, skip-level manager or HR head under the company's open door policy. It records the topic, why the normal reporting line is not suitable, the preferred meeting slot and whether the employee wants their manager informed.

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[Company Logo][Company Name]

OPEN DOOR MEETING REQUEST

Company:: [Company Name]
Request No.:: [Reference Number]
Date:: [Date]

Employee Details

Employee Name
Employee ID
Designation
Department
Reporting Manager
Contact Number / Email

Meeting Request

I would like to meet	[Leader Name / Designation] or HR Head
Preferred date(s) and time
Mode: In person / Phone / Video call
Approximate time needed

Topic

Concern about my work or role
Concern involving my reporting manager
Career or development discussion
Suggestion or idea
Feedback on a policy or change
Other

Brief description of what I wish to discuss
Why I prefer the open door route rather than my reporting line

Consent

My reporting manager may be told about this meeting
Please do not inform my reporting manager at this stage

The company encourages open communication. Using the open door policy will not affect your performance rating, career or treatment at work in any way, and the discussion will be kept confidential within the limits of company policy.

Employee
[Employee Name]
Date: [Date]

For Office Use

Meeting held on
Met with
Summary of outcome
Follow-up action and owner

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What this template includes

Name of the leader the employee wants to meet
Topic category and short description
Reason for using the open door route
Consent on whether the manager is informed
Preferred date, time and mode
Non-retaliation statement for using the policy

When to use it

An employee wants to discuss a concern with someone above their direct manager
The concern involves the reporting manager
A suggestion or career discussion needs a senior leader's view
The company runs an open door or skip-level policy and wants requests logged

How to customise this template

1List the leaders who participate in your open door policy
2Route the form to an executive assistant or HR inbox
3Set a target time to schedule meetings
4Add a virtual meeting option for remote staff
5Include an outcome section for the leader to complete

HR tips

Leaders should not reveal the request to the manager without the employee's consent
Treat open door as a conversation, not a formal investigation
If the matter is a serious complaint, guide the employee to the formal process
Track requests to see which teams use the open door most

For HR & hiring managers

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Frequently asked questions

What is an open door policy?+

A policy that allows employees to approach senior managers or HR directly with concerns or ideas, without going through their reporting manager.

Will my manager know I used the open door?+

Only if you agree or if the matter requires it. The form lets you choose.

Can open door be used for complaints?+

It can start the conversation, but formal complaints, including POSH matters, follow their own procedures.

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