Employee Grievance Form

  • Email Facebook Twitter Google+

Publication Date: 03/22/2011
Document Type: Printed Forms and Templates
Sponsor: Department of Personnel

Employees must complete an Employee Grievance Procedure Form to grieve problems not addressed through other procedures.

Attach additional sheets when necessary. DO NOT submit this form to address service ratings; examinations; benefits established by ordinance; classification of positions; equal employment opportunity complaints; or employment status including dismissals, demotions, layoffs, suspensions, reductions in pay, docks and denial of leave.

An employee should first discuss the problem with his/her immediate supervisor.


  1. Employee Grievance Form__ (26.83 KB)

Need Help Viewing?

You need a program that can open Adobe PDF files. A free option:

Was this helpful?      
Comments are helpful!
500 character limit
Feedback is anonymous.