All fields are mandatory unless otherwise indicated.

Name:
first name
middle name/initial (optional)
last name

Email:
Your email address will only be used to contact you in relation to your Formal Complaint.
If your email address changes, please email ombudsman-service@ircmcic.org with updated details, with your name in the Subject line.

Telephone number:
Your telephone number will only be used to contact you in relation to your Formal Complaint.

Address:
Country
Address
City/Town
County/State
Post code/Zip code

RELATIONSHIP BETWEEN THE COMPLAINANT AND RESPONDENT:

Complainants relationship with the Respondent:
---Coaching clientMentoring clientCoaching and Mentoring clientCoaching Student of a Formal Education BodyMentoring Student of a Formal Education BodyCoaching Student of a Private Commercial Training OrganisationMentoring Student of a Private Commercial Training OrganisationMember of a Professional BodyMember of a Support GroupClient of a Commercial OrganisationOther (please provide details in the Additional Information box below

RESPONDENT'S CONTACT DETAILS:

Name:
first name
middle name/initial (optional)
last name

Organisation name (optional):

Email:
This email address will only be used to contact the other party in relation to your Formal Complaint.
If this email address changes, please email ombudsman-service@ircmcic.org with your name in the Subject line detailing the updated details.

Telephone number:
This telephone number will only be used to contact the other party in relation to your Formal Complaint.

Address:
Country
Address
City/Town
County/State
Post code/Zip code

Other Parties Name and Contact details:
If there is more than one other involved, please email ombudsman-service@ircmcic.org with your name in the Subject line, providing the full name, relationship within this grievance, and full contact details.

REASON FOR YOUR REQUEST FOR FORMAL COMPLAINT:
Please select the relevant Code of Conduct/Core Competency heading(s) and provide further details including clause references, in the box below.
Please use the CTRL key to select more than one option.

Coaching and Mentoring Code of Industry Standards and Ethics
---PurposeEthical FoundationDefinitionsPersonal ConductProfessional ConductOrganisational ConductMonitoring and ManagingCoaching and Mentoring Industry Core CompetenciesOther (please provide details below)

Coaching and Mentoring Industry Core Competencies
---Understanding SelfSetting and Managing the RelationshipEffective CommunicationModels, Skills, Tools and TechniquesInsight, Growth, Learning, and DevelopmentActions, Outcomes, Accountability, and ResultsReflectionCoaching and Mentoring Code of Industry Standards and Ethics onlyOther (please provide details below)

Further details:

FURTHER INFORMATION:

Has this grievance been raised as a Request for Facilitation and Discussion with the Respondent?
---YesNo

Has this grievance been raised as a Request for Facilitation and Discussion with another organisation?
---YesNo

Has this grievance been raised as a Formal Complaint with the Respondent?
---YesNo

Has this grievance been raised as a Formal Complaint with another organisation?
---YesNo

Is this grievance the subject of a Court Case?
---YesNo

FURTHER DETAILS ABOUT YOUR REQUEST FOR FORMAL COMPLAINT:
In the fields below, please:
- provide a summary of how this Formal Complaint came about.
- explain the event that led to this Request for Formal Complaint.
- explain the actions of both the Complainant and the Respondent that led to this Formal Complaint.
- provide an explanation of the type(s) of communication between the Complainant and the Respondent.
- any further relevant information.

Summary:

Events:

Actions of Complainant:

Actions of Respondent:

Communication between Complainant and Respondent:

What was the point at which you decided that you needed to contact the Ombudsman Service?:

If you have documentation to support your Formal Complaint, please upload the documentation (optional). If you wish to forward your supporting information by email, please email ombudsman-service@ircmcic.org with your name in the Subject line.

Any further relevant information?
Please enter ‘none’ if there is no further relevant information.

PREFERRED OUTCOME:
What are you expecting as a resolution to your Formal Complaint?

ADDITIONAL INFORMATION:
Please enter any Additional Information relevant to your Formal Complaint (optional)

How did you hear about the Ombudsman Service?
---previously registered Request for Facilitation and DiscussionRespondentSearch engineSocial mediaAdvertOther

By submitting this form, I confirm that I have read the full Ombudsman Service Policy and Procedures and give authority for the information submitted on this form and all emails to be (1) shared with the other party or parties detailed, (2) shared with other relevant parties, unless I have stated that I do not want this information to be shared in the Additional Information box above.

By submitting this form, I confirm that all information received on this form and through all other requests for information by the Ombudsman Service (1) may be utilised to progress and bring this Formal Complaint to a conclusion, (2) may be stored in the Ombudsman Service Register of Complaints, Outcomes, and Sanctions, (3) may be retained for as long as all relevant parties remain within the Coaching and Mentoring Industry, or for longer if necessary.

By submitting this form I acknowledge that all Ombudsman Service Policy and Procedures will be followed and documented.