Human rights complaint form and guide
if you want to review the self-assessment questionnaire again.
Instructions for the form
Instructions on how to complete the form are in the
Complaint Guide. Review the guide before completing the
Complaint Form. The form works best in Adobe Reader. Links to this free software are at the bottom of the page.
Complaint Guide (English).pdf
Guide de plainte (Français).pdf
Human rights complaints about vaccines
The Commission may accept a complaint when someone has a disability or religious belief and they allege that there was discrimination in employment, services, or tenancy. Early in the complaint process, a person making a human rights complaint on the ground of mental disability or physical disability will need to provide medical information to confirm they have a disability that prevents them from being vaccinated for COVID-19. Someone who wants to make a complaint on the ground of religious beliefs will need to support that their belief that they cannot be vaccinated is sincerely held and connected to their faith.
Completing the form
You can download the form to your computer. Save the form to your computer first. Enter your information on the form and save it. This is the preferred method.
Alternatively, you can print the form and handwrite your complaint on the form. Please note, if you are printing your complaint form, print the form on one side only, leaving the back pages blank. This also applies to any additional pages.
Add extra pages if you need more space to answer questions, up to a limit of 20 single-sided pages, including the form. The form has a place to list documents (if you have any) that relate to the complaint. Do not send these documents; they may be requested later in the complaint process.
Complaint Form (English).pdf
Formulaire de plainte (Français).docx
Separate form needed for complaints under Section 10 of the Act
If you want to file a complaint because you believe someone retaliated against you or if someone made a complaint against you that has no basis, use the
Section 10 Complaint Form.
Additional form for representatives
You may need or want someone to represent you during the complaint process. You must fill in an
additional representative form if someone
other than a lawyer is representing.
To request a print copy of any form, email email@example.com
or leave a message at
. To call toll-free within Alberta, dial 310-0000.
Upon request, the Commission will email or mail you a large print version of the
Complaint Guide or the
Submitting your complaint form
Email your completed form to firstname.lastname@example.org
. A Human Rights Officer will assess your complaint and, in time, they will advise you whether your complaint is accepted.
If you are not able to email your completed form, you can mail or fax to, or drop off at, either Commission office.
Southern Regional Office
200 - 620 7 Ave SW
Calgary, AB T2P 0Y8
Northern Regional Office
800 - 10405 Jasper Ave NW
Edmonton, AB T5J 4R7
Revised: February 27, 2023