If you have experienced or witnessed an incident that you are concerned about and may fall under the category of exclusion, discrimination, harassment, or any other form of unacceptable behaviour within the St. Jerome’s University community, you are invited to complete this form. You can also use it to help us identify areas where there might be a need for improvement in terms of equity, diversity and inclusion (EDI). The purpose of this form is to help community members get their information to the right person as quickly as possible so that they can be informed of relevant support services and university policies and processes.

This form can be used to submit anonymous reports for those not comfortable disclosing their identity. No identifying information is collected through submission of this report unless you choose to disclose.

This form will be received by St. Jerome’s University’s Director, Human Resources to review and direct to the most appropriate department/person. You will receive a response within three business days from the Director, Human Resources (or their delegate if they are out of office) to notify you which department/person your submission has been directed to (unless no response needed has been indicated). 

The information in this form will only be provided to individuals or offices as required in order to provide support or address your concern. If you disclose your identify, you will be notified if there is a need to inform any other offices or individuals at St. Jerome’s University or University of Waterloo about the information shared. The confidentiality and privacy of those who have submitted reports will be respected to the greatest extent possible. There are situations where there are limits to confidentiality, such as when legal obligations exist to report or investigate incidents. If you disclose your identity, the department/person your report is directed to will discuss any limits to confidentiality with you that may exist.

This form and process does not replace or override any university policy or Collective Agreement, both of which would be followed if/when the form resulted in information relevant to such documents. 

If you have any questions about this form, they can be directed to the Director, Human Resources (michelle.watson@uwaterloo.ca).