Equity, Diversity and Inclusion: Report and Support Form

If you have experienced or witnessed incidents 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 we can improve on equity, diversity and inclusion (EDI).

 

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.

 

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

Prior to submitting this form, you will have the ability to go back and change the answer to this question if desired.

If you have experienced or witnessed harm, please be aware of the following policies and offices that could be of assistance to you:

Preventing and Responding to Workplace Violence and Harassment and Sexual Misconduct (SJU policy)

Prevention of and Response to Sexual Violence (UW Policy 42)

Accessibility for Persons with Disabilities (SJU policy)

Ethical Behaviour (UW Policy 33)

UW Sexual Violence Prevention and Response Office svpro@uwaterloo.ca

UW Office of Equity, Diversity, Inclusion and Anti-Racism equity@uwaterloo.ca

UW Office of Indigenous Relations indigenousrelations@uwaterloo.ca UW Accessibility Services access@uwaterloo.ca

UW Counselling Services (for students) 519-888-4096

Employee and Family Assistance Program (for employees): Dialogue Health Technologies https://app.dialogue.co/

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