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HA Maltreatment Allegation Form

The Maltreatment & Discrimination Allegation Intake Form is intended to bring forward any allegations of Maltreatment, specifically of discrimination, including verbal taunts, insults or intimidation based on discriminatory grounds (race, national or ethnic origin, colour, religion, age, sex, sexual orientation, gender identity or expression, marital status, family status, genetic characteristics, disability or language).

Allegations received will be forwarded to the required parties to determine if a formal investigation needs to take place. Allegations that are substantiated through investigation will be considered for suspensions and/or sanctions.

By completing this form, you agree that Hockey Alberta may share the information contained here within with other parties or individuals in order to investigate the allegation brought forth.

Maltreatment & Discrimination Allegation Intake Form

Required Fields *


Complainant - Individual Making the Allegation (You)

() - -
Check at least one of the following:


Target of the Maltreatment Incident (If different from above)

() - -

Respondent - Individual Allegation is being made against

() - -

Additional Individuals Allegation is being made against (Did anyone else contribute to the incident?)

() - -

Maltreatment Incident Details

Check at least one of the following:




Check at least one of the following: