[Company Logo][Company Name]
WORKPLACE COMPLAINT FORM
- Site / Unit:
- [Work Location]
- Form No.:
- [Reference Number]
- Date:
- [Date]
Anyone working at this site may use this form. You may give your name or leave it blank. For complaints of sexual harassment please contact the Internal Committee: [IC Presiding Officer Name], [Phone].
About You (optional)
| Name | |
|---|---|
| Employee ID / Gate Pass No. | |
| Category: Employee / Contract Worker / Trainee / Apprentice | |
| Contractor Company (if applicable) | |
| Department / Line | |
| Shift | |
| Contact Number |
Type of Complaint
- Safety hazard or unsafe practice
- Washroom, drinking water or hygiene
- Canteen or food quality
- Transport or shuttle
- Wages, overtime or deductions
- Behaviour of a person
- Equipment, PPE or tools
- Other