All fields are required unless otherwise stated.
Your first name:
Your last name:
Your email address:
Your email address will only be used to contact you in relation to your Request for Facilitation.
Please confirm your relationship with the respondent (Client, Student of a Training Organisation, or Member of a Professional Body)
---Coaching clientMentoring clientTraining organisation - coaching studentTraining organisation - mentoring studentProfessional BodyOther (please provide details below)
Respondent contact email address:
REASON FOR YOUR REQUEST FOR FACILITATION:
Please enter the relevant clause or clauses from the Unified Code of Industry Ethics and/or the competency or competencies from the Unified Coaching and Mentoring Industry Core Competencies.
Unified Code of Industry Ethics:
Unified Coaching and Mentoring Industry Core Competencies:
Please provide full details of how this request for facilitation came about. Explain the event, the actions, the communication, and all relevant information.
Have you raised this request for facilitation as a request for facilitation or complaint with the Respondent?: ---YesNo
Have you raised this request for facilitation as a request for facilitation or complaint with a Professional Body?: ---YesNo
Is this dispute, grievance, or complaint subject to Court Proceedings?: ---YesNo
If you have answered 'yes' to one or more of the questions above, please provide (1) the status of your proceedings and (2) where applicable, the outcome.
Please enter any FURTHER INFORMATION relevant to your Request for Facilitation? (optional):
I am a real person.
By submitting this form, you confirm that you give authority for the information submitted on this form and any further information provided to support your Request for Facilitation to be stored and processed in the Ombudsman Service Register of Complaints, Outcomes, and Sanctions.
Currently all information provided by and correspondence with the IRCM is in English.