Behavioural complaint resolution form – Stage 2 – Formal Resolution
PRIVACY DECLARATION
The information is collected by GOTAFE for the purpose of responding to complaints. The information will be kept confidential
to the organisation and will be securely stored. Only people required to know, such as the GOTAFE Contact Officer, Commercial
Manager or Team Leader, the person against whom the complaint has been made and any potential witnesses will be provided
with details of this complaint. It also may be used as a reference when reviewing other similar complaints lodged after this
complaint has been resolved.
PROTOCOLS IN RELATION TO ANY PARTY INVOLVED WITH A COMPLAINT PROCESS
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True and accurate disclosure and co-operation is essential in establishing the facts.
Confidentiality is to be maintained at all times to avoid defamation. No discussion about the fact that there has been an
interview or what has been said in the interview should occur.
GOTAFE will regard breach of confidentiality as serious misconduct and may take disciplinary action against this person.
You will conduct yourself in a professional manner and observe appropriate workplace behaviours. You must not
victimise anyone during or after this investigation.
You can complete this form yourself or with the assistance of the GOTAFE Contact Officer, a trusted colleague or
member of People and Performance. You will need to sign this document, stating that the record is true and correct.
Any allegations raised in this interview about another individual will be put to that individual, so that person will have
the opportunity to respond to the allegation and ensure procedural fairness.
You can contact your support person/union at any stage concerning this process. You have been advised of your right to
have a support person/union representative present at this interview and at any further interviews.
You confirm that to the best of your knowledge, there exists no actual or perceived conflict of interest that may
influence your conduct throughout these proceedings.
Steps Taken to Resolve Complaint at Stage 1?
Initiators written, signed and dated statement attached as required?
Is a Mediator to be appointed?
(If Yes, please consult with Executive Manager, People and Performance)
Does the incident appear to highlight serious misconduct?
(If Yes, please advise the relevant Commercial / Support Manager).
Initiators name
Initiators position
Initiators contact #
Initiators signature
Date
Respondents name
Respondents position
Respondents contact #
Respondents signature
Date
INCIDENT DETAILS (please circle)
Type of Complaint?
Physical
Non-verbal
Verbal
Other
Gender base of Incident?
Male to Female
Female to Male
Male to Male
Female to Female
Were there witnesses to the
behaviour? Who?
Is the Complainant? (please circle)
Permanent Employee
Contract Worker
Casual Worker
Team Leader / Commercial Manager
Executive Manager
Volunteer
Student
Parent / guardian
FHR-97
Is the Respondent? (please circle)
Permanent Employee
Contract Worker
Casual Worker
Team Leader / Commercial Manager
Executive Manager
Volunteer
Student
Parent / guardian
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Division (optional)
Location
Respondent in same Division / Department /
Location? If No, please provide.
Department (optional)
Complaint Detail (Provide specific details about the behavioural/issues of Respondent). Please also attach signed, dated,
written complaint.
Complaint Detail
Date / Time
Location
Witnesses
CHOSEN ACTION / ACTION TAKEN
Resolved by Contact Officer / Parties to Complaint
Matter escalated to Stage 3: Reason?
Matter referred to Executive Manager, People and Performance: Reason?
Matter referred to relevant Manager: Reason?
Other undertakings for resolution / comments / suggestions:
Are you satisfied with the outcome?
Yes
No (matter to be escalated)
By whom has the matter been escalated? Contact Officer / Other: ___________________________
Notes
FHR-97
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INITIATOR / RESPONDENT ACCEPTANCE
INITIATOR
RESPONDENT
Name
Position title
Work location
Copies provided?
I hereby sign my acceptance that the matter has
now been resolved and required no further action
at this time.
Signed
Date
Name
Position title
Work Location
Copies provided?
I hereby sign my acceptance that the matter has
now been resolved and required no further action
at this time.
Signed
Date
CONTACT OFFICER USE ONLY
Name
Position title
Work location
Filing date
FHR-97
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