Document a Problem, Connect With Your Local - Health Professionals & Allied Employees

Document a Problem, Connect With Your Local

Below are links to forms which you can use to document workplace problems and assist your local leaders in resolving problems at the hospital, including inadequate staffing. The forms can be downloaded and printed.

Assignment Despite Objection Form

Mandatory Overtime Complaint Form

No Break Sheet

Notice of Unsafe Staffing Situation

We also encourage you to fill in the information below and let us know more about the issues you are concerned with. A member of the Local Executive Board will follow up and contact you.


    Your Name (required)

    Your Email (required)

    Phone Number

    Department/Unit (required)

    Shift Hours (required)

    Form Needed

    Please describe the problem in more detail.