COMPLAINT / ENQUIRY FORM

Please refer to the Policy on Equal Opportunity and the procedures for handling discrimination/harassment complaints before filling out this form. [Web link= http://www.eounit.hku.hk/eng/] Upon receipt of a complaint, the matter shall be referred to the Equal Opportunity Officer who shall first ascertain whether the complainant is aware of the steps to resolve the complaint informally and whether the complainant wishes to make use of such steps to attempt to resolve the complaints informally. With the consent of the complainant, the Equal Opportunity Officer shall attempt, and if appropriate, with the assistance of other person, to resolve the complaint informally.

Please complete all relevant fields so your complaint will be handled expeditiously. Sign the form and send it to: Equal Opportunity Unit, Attn: Equal Opportunity Officer, 107 Main Building, Pokfulam Road, The University of Hong Kong; or fax to: 2549-6285, or email to: eounit@hku.hk

Please include your contact information and sign this form, so that the EOU will be able to respond to you regarding the subject matter as soon as possible. Please retain a copy of your complaint/enquiry, including any attached materials, for your records. Do not send original documents, they will not be returned. Send copies.

Our Policy on Equal Opportunity prohibits the following discrimination/ harassment cases. Please kindly indicate which of the following is/are applicable to your complaint/enquiry:

SECTION 1: PERSONAL INFORMATION

If you are a student, please complete the information below:

If you are a staff member, please complete the information below:

SECTION 2: INFORMATION ABOUT YOUR COMPLAINT/ENQUIRY

Please describe your complaint/enquiry in detail. Include the names of persons, locations, and dates involved. Use additional sheets if you need more space.

Is there any supporting evidence? (Evidence could include voice recordings, photos, text messages, emails, etc.) Please list below the supporting materials available to you and attach copies if possible. Also, suggest those which may be helpful but unavailable to you (e.g. CCTV footages)

Any witnesses who were present at the scene? Any passers-by who may have coincidentally witnessed the case? Please list details of the witnesses if it is known to you (full name, contact no., Email, occupation, etc.)

What attempts have you made to resolve this complaint up to now? Please state who you contacted and what action, if any was taken.

Why do you think the complaint was not able to be resolved in your prior attempts?

What outcome are you looking for?

Personal Information Collection Statement

The personal information provided by you herewith will be used for the purposes and activities of and related to the complaint/enquiry you have filed. It might also be disclosed or transferred to any other parties for the above purposes and activities. Under the Personal Data (Privacy) Ordinance, you have the right to request access to and/or correction of your personal data held by the University. Requests should be made to the Data Protection Officer at privacy@hku.hk. The Privacy Policy Statement of the University can be accessed at http://www.hku.hk/privacy_policy/

Your complaint/enquiry will be treated in strict confidence and will be disclosed to those relevant parties, on a need-to-know basis, with your consent.

Is there any person in particular who you do NOT want to be told of your complaint/enquiry? (Keep in mind that it may be difficult to resolve if those involved cannot be asked to explain or respond). NOTE: RETALIATION AGAINST A COMPLAINANT FOR MAKING A COMPLAINT IS ABSOLUTELY PROHIBITED. SUCH CONDUCT IS AN ACT OF VICTIMIZATION AND WILL BE TAKEN SERIOUSLY AND FOLLOWED UP WITH NECESSARY ACTION (for more details on victimization, please refer to http://www.eounit.hku.hk/eng/procedures.php)

I hereby certify that the above information is true and correct to the best of my knowledge and belief. I grant permission for this complaint/enquiry and the materials submitted (or to be submitted) to be disclosed to relevant parties for purposes of investigation and response.

Revised: 17/11/2015

Download Complaint / Enquiry Form in .docx version