PMHA Formal Complaint Form
Information on the Parties Involved
Email *
Team
Name of Complainant
Phone Number for Complainant
Person complaint is about: Coach, Assistant Coach, Trainer, Manager, Player, Parent, Board Member, Other
Incident / Complaint Detail Please include as many specific facts and details as possible Date and Approximate Time of Incident:
Details of Incident: Provide a summary of ALL the details of the issue/incident and any other relevant facts. Please include the name of the relevant player.
Steps Taken to Resolve the Issue Has an attempt been made to resolve the issue?
Clear selection
Have you spoken with the Team Manager about the issue?
Clear selection
Who did you speak with?
When did you speak with them?
What was the result? What steps were taken to resolve the issue?
Did you speak with your Vice President of your team? VP 1- Peewee, Bantam, Midget VP 2 IP, Novice, Atom
Clear selection
Who did you speak with?
When did you speak with them?
What was the result? What steps were taken to resolve the issue?
What do you think is a reasonable resolution to this issue?
I acknowledge that the statements made above are to the best of my knowledge accurate, complete and truthful. Please print your name below.
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy