Intake Questionnaire

SECTION ONE – SELF-ASSESSMENT

The Saskatchewan Human Rights Code, 2018 sets out what types of complaints the Commission can accept. Not every type of concern is covered by the Code.

Note: while you do not need a lawyer to use this complaint process, in some cases you may still wish to seek legal advice at your own cost.

In order for us to accept your complaint, the following three things must be true:

  1. You have a protected characteristic under the Code (for example: race, religion, sex, etc.)
  2. You have experienced negative treatment in an area protected by the Code (for example: work, school, housing, etc.)
  3. Your protected characteristic was a factor in that negative treatment.

The questions in this section will walk you through these points.

Your answers will help determine whether the Commission can accept your complaint.

If you need accommodation, language assistance, or another way to provide information, please contact us directly at [email protected] or 306-933-5952.

I EXPERIENCED DISCRIMINATION

(Select the situation which describes your situation the best. If you have experienced discrimination in different situations, you may need to submit a complaint about each of them separately.)

The Commission can only accept complaints of discrimination in protected areas outlined in The Saskatchewan Human Rights Code, 2018.

WHY DO YOU THINK THIS HAPPENED?

(Select a characteristic that applies to your situation. If multiple characteristics apply, select the one you feel is the most significant.)

The Commission can only accept complaints of discrimination based on the protected characteristics outlined in The Saskatchewan Human Rights Code, 2018.

If you have a complaint in the area of employment (e.g. termination, severance, vacation pay, etc.) and it is NOT linked to one of the protected characteristics, contact Employment Standards, your union, or a lawyer.

For general workplace complaints between an employee and employer within a unionized (or non-unionized) work environment contact Saskatchewan’s Labour Relations and Mediation’s Conciliation and Mediation Services.

If you have been harassed at work but it was NOT linked to a protected characteristic, contact Occupational Health and Safety – Harassment and Discriminatory Prevention Unit. If you are a union member, please seek assistance from your union.

If your complaint involves the conduct of a municipal or provincial police service (for example, city police or the Saskatchewan Marshals Service)  and is NOT related to a protected characteristic, it should be sent to the Public Complaints Commission.

If you have a complaint about the conduct of a member of the RCMP and is not related to a protected characteristic, it should be submitted to the Civilian Review and Complaints Commission for the RCMP ( new link: https://rcmp.ca/en/services-and-information/making-public-complaint-against-rcmp-member)

If your complaint is about the Government of Saskatchewan or a municipal government in this province and is NOT linked to a protected characteristic, you may be able to file a complaint with Ombudsman Saskatchewan.

Inmates of provincial correctional facilities who have a complaint about general mistreatment or breach of rights (food quality, right to a lawyer, etc.) that is NOT linked to a protected characteristic should also contact Ombudsman Saskatchewan.

If your complaint is against the Saskatchewan Health Authority staff, physicians, or healthcare professionals and NOT linked to a protected characteristic, contact the Client of Office Concerns – Patient or Client Concerns and Feedback.

Complaints between landlords and tenants that are NOT linked to a protected characteristic can be made at the Office of Residential Tenancies.

Complaints against private care homes in SK can be filed at Personal Care Homes | Care at Home and Outside the Hospital | Government of Saskatchewan

DID THIS HAPPEN ON A FIRST NATIONS RESERVE?
Who were you dealing with on a First Nations reserve?

The Commission cannot accept complaints against First Nations governments or bands, as these fall under federal jurisdiction. The Canadian Human Rights Commission deals with these complaints.

Please contact the Canadian Human Rights Commission.

WERE YOU DEALING WITH ONE OF THE FOLLOWING?

 

  • A federal government ministry or agencies (Service Canada, Immigration, Refugees and Citizenship Canada, the Canadian Forces, etc).
  • A federal Crown corporation (Canada Post, Canadian Broadcasting Corporation, VIA Rail, etc.)
  • Bank
  • Airport or airline
  • Ship or navigation
  • TV or radio station
  • Phone or Internet provider
  • Transportation company (ferry, train, truck, or bus that travels between provinces)
  • RCMP

The Commission cannot accept complaints against organizations that operate within federally regulated industries. The Canadian Human Rights Commission deals with these complaints.

DID THIS HAPPEN IN SASKATCHEWAN OR WAS AN ORGANIZATION IN SASKATCHEWAN INVOLVED?

The Commission cannot deal with issues outside of Saskatchewan. Please contact the human rights commission in the province or territory where the incident took place for more information.

WHEN WAS THE LAST TIME THE DISCRIMINATION HAPPENED? (PLEASE NOTE THAT A COMPLAINT MUST BE FILED WITHIN 12 MONTHS OF THE LAST DATE OF DISCRIMINATION).

Under The Saskatchewan Human Rights Code, a complaint must be filed within 12 months of the last date of discrimination. However, the Chief Commissioner has discretion to extend this limitation period only if it is appropriate in the circumstances to do so. If you believe an extension should be considered, please contact us at [email protected] for further assistance.

Based on your selections, the Saskatchewan Human Rights Commission may be able to accept your complaint.

The complaint process may be started by completing an Intake Questionnaire

If you have questions or want to talk to someone at the Commission, contact us at (306) 933-5952 or [email protected]

SECTION TWO – INTAKE QUESTIONNAIRE

The Commission reviews and responds to complaints under The Saskatchewan Human Rights Code in an impartial, fair and timely manner.

To help us do this, everyone involved in the complaint process must be cooperative and act respectfully.

What we ask of participants:

  • Treat Commission staff and others with respect
  • Communicate honestly
  • Cooperate with Commission staff
  • Meet all deadlines

What is not acceptable:

  • Discriminatory or offensive language
  • Aggressive or abusive behavior, including verbal or physical threats
  • Unreasonable demands or repeated unnecessary contact

If these expectations are not met, the Commission may limit services or dismiss your complaint.

Before you begin:

The Intake Questionnaire (IQ) is the first step to determine whether a complaint may proceed. Your IQ will first be assessed by commission staff.

Is there a fee?
There is no cost to file a human rights complaint.

What information is required?
The Intake Questionnaire asks you to provide key details. The information you provide should be clear and concise. You do not need to use legal language. Later, after submitting the IQ, you may be asked to provide further information or documents.

Do I need a lawyer?
A lawyer is not required. But you may choose to speak to one, or have one help you, at any point, at your own expense.

Is there another way to submit the IQ?
If you need accommodation, language assistance, accessibility support, or another way to submit your information, please contact us. We will work with you to find an appropriate option.

Completing your Intake Questionnaire:

  • This online IQ is the preferred way to submit your complaint.
  • If you cannot use this online form, a printable PDF version is available
  • The online IQ has 8 steps. Your information will not be saved if you close your browser. You may wish to prepare longer responses in a separate document before copying them into this form.
  • Please remember to hit “Submit” at the end in order for the Commission to receive your IQ. You will receive an email verifying that we have received your IQ.
  • Please complete all sections that are relevant to your situation.
  • Items marked with * are required fields.

Information you provide will be handled in accordance with the Commission’s legal responsibilities and privacy obligations.

STEP 1 – 📇 CONTACT INFORMATION

The Commission collects your contact information so we can communicate with you throughout the complaint process.

Full Legal Name *
Preferred Name *
Preferred Pronouns
Are you making this complaint on behalf of a dependent? *

If so, please provide the dependent's details:

Full Legal Name *
Preferred Name *
Preferred Pronouns *
Mailing Address *
Town/City *
Province *
Postal Code *
Telephone *
Email address *
Do you have a Legal Representative?

If so, please provide their name and contact information

Representative Name *
Contact Information *

If you have a legal representative would you like our communications to go to yourself only, you and your legal representative, or only your legal representative? Please check one.*

Someone who does not live with you, but who can contact you and with whom we may discuss your claim.

Name
Mailing Address
Town/City
Province
Postal Code
Phone
STEP 2 – 👤 🏢 COMPLAINING AGAINST

Give as much information as possible about the person or organization who you feel has discriminated against you.

Person or Organization Name *
Other persons or organizations
Mailing Address
Town/City
Province
Postal Code
Phone
STEP 3 – ⚖️ DETAILS OF DISCRIMINATION

Select the protected characteristic(s) you believe were factors in the discrimination you experienced. Select all that apply. *

Where did the discrimination take place? *

STEP 4 – 💼 IF EMPLOYMENT RELATED
Position Held *
Rate of Pay ($/hr)
First Day Worked *
Are you still working at the organization *
Describe your work status (select all that apply): *
STEP 5 – ⏳ PRIOR ACTION
Are you represented by a union? *

Have you addressed this matter with other agencies? This could include:*

  • Employment Standards
  • Workers’ Compensation Board
  • A professional body engaged in the oversight of its members e.g. College of Physicians and Surgeons of SK
  • Office of Residential Tenancies
  • A court/civil action
STEP 6 – 📁 PARTICULARS OF COMPLAINT
Please provide details of your complaint

When did the discrimination happen? Be as specific as possible. *

Tell us how you feel you were discriminated against? *

What was said or done? *

How do you believe what happened is related to the protected characteristic you selected in Step 3 of this questionnaire? *

Who was involved? *

Were there any witnesses? If so, please include names and what they might say. *

Do you believe anyone else experienced the same treatment? *

How has this affect you? (Your mental health, physical health, financial wellbeing, etc.) *

Have you taken any steps to resolve the situation? Please describe. *

If not, why?

If yes, what was the outcome?

STEP 7 – 📝 PARTICULARS OF COMPLAINT

LIST supporting documents (if you have any) that confirm the facts or a given record of events. These might include:

  • emails or texts;
  • medical records or notes;
  • minutes of meetings;
  • termination letters;
  • Record of Employment; or
  • documents from other action taken (e.g. union grievance, WCB Claim, etc.)

You will have an opportunity to provide documents later in the complaint process.

CONDUCT AGREEMENT

Please review the Commission’s Individual Rights and Mutual Responsibilities of Parties to a Complaint guidelines. The Saskatchewan Human Rights Commission has a zero tolerance policy for any harm, abuse, or threats toward its staff. Such behaviour may result in the Commission refusing to take further action, and any criminal conduct will be reported to the police. Legal action may also be considered.

SIGNATURE AND SUBMISSION



Full name of Complainant: *
Date Of Submission: *
We have successfully received your Intake Questionnaire. A member of our team will connect with you shortly to guide you through the next steps.