Oregon Federation of Nurses and Health Professionals - OFNHP - AFT

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Grievance Form

Discovery Form

Initial Discussion

When you send the form, it should automatically send a copy to the Internal Organizer. It's a good idea, though, to check with the union office to be sure it was received. 503.657.9974.

Local 5017 OFNHP Grievance Form
* Grievance Name:	(Please give your grievance a name)
* Grievant:
* Clinic:
Grievant Address
Address 1:
Address 2:
City:
State:
ZIP Code:
Phone:

Bargaining Group:
Coded Hours:
Step:	1 2 3 4
Date:
Steward:
Steward Address
Address 1:
Address 2:
City:
State:
ZIP Code:
Phone:

Work Site:
Inpatient/Outpatient:	Inpatient 7/70 5/40 Other

* Description:	Give a brief description of the grievance (date, time, shift, who was involved, specific incident, etc
Contract Violations:	Include Article(s) and Section(s)
Remedy:
Signature:
Date Submitted:

Employer Answer:
Signature:
	Employer, please include name, title and date in your response.
Send Form to:
* Employer Email:
* Grievant Email:
* Steward Email:
	( Form is automatically sent to the Internal Organizer at OFNHP. Please contact the office to be sure this form was received. )

* Verify:	Enter the letters and numbers from the image above.