Grievance Form Name(Required) First Last Email(Required) Phone(Required)Today's Date Month Day Year Incident Details(Required)Please include the following: - Date of incident - Location of incident - Complete description of incidentDid you attempt to resolve the issue with the individual against whom the grievance is directed? If so, what was the outcome?(Required)Please describe what specific redress or solution you seek.(Required)Consent(Required) I acknowledge that by checking this box I am providing representatives of ERI the authority to review this incident by any means determined necessary.
