Anonymous reporting form

Anonymous reporting form

This form is intended to provide Ontario Tech University faculty, staff and students with a confidential channel to anonymously report acts of harassment or discrimination that they have experienced in their connection to the University, for the purpose of data collection. In an anonymous report, the individual sharing their experience will remain unknown to the University and will not be asked to share any personal information.

The information provided through this form will be collected by the Human Rights Office and may assist in identifying patterns of behaviour and take appropriate action to support community well-being.

All information provided through this form will remain confidential. If you require this form in an alternate format, please let us know by e-mail: humanrights@ontariotechu.ca

To report a matter to the University for action, proceed to our Report Form

To learn more about the Human Rights Office’s procedures or access support resources, Book a Consultation.

Are you currently an Ontario Tech faculty member, staff or student?

Are you currently an Ontario Tech faculty member, staff or student? Yes No
Have you ever been an Ontario Tech faculty member, staff or student?

Have you ever been an Ontario Tech faculty member, staff or student? Yes, less than 1 year ago Yes, between 1-5 years ago Yes, greater than 5 years ago No
What type of concern are you reporting?

What type of concern are you reporting? Discriminatory Harassment Hate Incident Discrimination Failure to Accommodate Workplace Harassment Workplace Sexual Harassment Reprisal Other Other
If this matter is linked to a Protected Ground, please identify all that apply.

If this matter is linked to a Protected Ground, please identify all that apply. Age Ancestry Citizenship Colour Ethnic origin Place of origin Race Creed (religion) Disability Family status Gender expression Gender identity Sex (gender) Sexual orientation Marital status Record of offences None Other Other
Date of the most recent incident Date of the most recent incident / MM / DD YYYY
Provide a description of your complaint
Maximum of 250 characters allowed. Currently Entered: 0 characters.
Privacy Statement

Personal information on this form is collected under the authority of the University of Ontario Institute of Technology Act, SO 2002, c. 8, Sch. O. and will be collected, protected, used, disclosed and retained in compliance with Ontario’s Freedom of Information and Protection of Privacy Act R.S.O. 1990, c. F.31. This information will be used to administer the University’s Human Rights dispute resolution processes. Questions regarding the collection of your personal information may be directed to: Ontario Tech University Access and Privacy Office, 2000 Simcoe Street North, Oshawa, ON L1H 7K4, 905.721.8668, ext. 6705, email: accessandprivacy@ontariotechu.ca