Notice of Occurrence form - Harassment and Violence in the Workplace

If you need emergency assistance or feel unsafe:

  • On a base, wing, or in a National Defence building: Call the military police.
  • Off National Defence property: Call 911.

Instructions

Instructions for principal party or witness

Before filling out the form, please review the definition of Workplace Harassment and Violence:

The DAOD 5014-0 and policy manual define harassment and violence as:

“any action, conduct or comment, including of a sexual nature, that can reasonably be expected to cause offence, humiliation or other physical or psychological injury or illness to an employee/member, including any prescribed action, conduct or comment.”

This includes any behaviours based on the prohibited grounds of discrimination identified in the Canadian Human Rights Act, which include race, national or ethnic origin, colour, religion, age, sex, sexual orientation, gender identity or expression, marital status, family status, genetic characteristics, disability and conviction for an offence for which a pardon has been granted or in respect of which a record suspension has been ordered.

You can submit your Notice of Occurrence (NoO) either:

Instructions for Chain of Command/manager

If the principal party or witness wants to make a verbal notification, please ask them to provide the information for each of the fields below. If they wish to remain anonymous, do not record their first and last name.

Before you fill out the form, please be sure to review the following with the principal party or the witness:

You will be required to track and report this NoO to the WHVP Center of Expertise (CoE): WHVPCoE-PHVCE@forces.gc.ca, in accordance with DAOD 5014-0.

Protection of privacy and confidentiality

The information provided in the NoO form is collected by the Department of National Defence (DND) and Canadian Armed Forces (CAF) in accordance with the National Defence Act, the Public Service Staff Relations Act, Canada Labour Code, the Work Place Harassment and Violence Prevention Regulations and DAOD 5014-0. The information is collected for the purposes of documenting and investigating workplace harassment and violence occurrences in accordance with the DND/CAF responsibilities.

The information provided in a NoO will be read by the Chief of Professional Conduct and Culture (CPCC) Designated Recipient and CoC/Manager. If the resolution process proceeds to conciliation/Alternative Dispute Resolution (ADR) or WHVP investigation, a summary of the NoO will be shared with the conciliator/ADR practitioner or a WHVP investigator. The NoO will also be shared with the responding party and may be shared with witnesses if the resolution process proceeds to a WHVP investigation. In limited and specific situations, your personal information may be disclosed without your consent in accordance with subsection 8(2) of the Privacy Act.

The investigation report will not include any information, directly or indirectly that may lead to the identification any of the named individuals within an occurrence. The report will be shared with the CoC/Manager, principal party, responding party, and the applicable local Health and Safety Committee (HSC), Health and Safety Representative (HSR) or Canadian Armed Forces Safety Committee (CAFSC).

Completion of the NoO is voluntary and any personal information provided will be used and protected in accordance with the Privacy Act, and as described in the Standard Personal Information Bank Harassment - PSE 919. The Privacy Act provides you the right to request access to and correction of your personal information. For more information about these rights - or about our privacy practices - please contact the DND/CAF Access to Information and Privacy Coordinator. You also have the right to file a complaint with the Privacy Commissioner of Canada regarding our handling of your personal information.

Definitions

Principal Party or witness information

You can submit a NoO anonymously. For verbal NoOs, inform the Chain of Command/manager or Designated Recipient of your wish to remain anonymous. For written NoOs, check the anonymity box.

Witness

If you name a Principal Party, the CoC/manager or the Designated Recipient will contact the Principal Party to ask if they wish to begin the resolution process. If the Principal Party refuses to participate in the resolution process, the resolution process is considered closed, but a redacted version of the NoO will be shared with the applicable Workplace Health and Safety Committees/Health and Safety Representatives or Canadian Armed Forces Safety Committees who will review and, if necessary, update the WHVP assessment to determine if any additional preventive measures are required.

Where inadequate information exists to determine what actual workplace is involved, the L1 WHVP advisor or appropriate level in the CoC/manager, may provide direction to all subordinate workplaces to review their assessments to ensure they cover the specific risk factors in question if warranted.

Principal Party

If you choose to remain anonymous and incomplete information is provided in order to determine what actual workplace is involved, then the NoO will be closed.

If information allows to identify the workplace, then a redacted version of the NoO will be shared with the applicable Workplace Health and Safety Committees/Health and Safety Representatives or Canadian Armed Forces Safety Committees who will review and, if necessary, update the WHVP assessment to determine if any additional preventive measures are required.

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