Grievance/Incident Submission Form
Use this form to submit a concern or complaint after you have attempted to resolve the issue(s) with your team leadership without adequate response. If you suspect a SafeSport violation has occurred, stop now, consult the Safesport guidance and reporting options at https://www.usahockey.com/makingareport  If you suspect a criminal offense, contact law enforcement immediately and report to USA Hockey Safesport.  If you are unsure, proceed with submitting your concerns here.

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Email *
Your Full Name *
Your Email Address *
Your mobile home number *
What team is involved in the incident(s) being reported *
What is the name of your team’s head coach *
What is the name of your team manager *
Describe the incident(s) of concern. Provide dates, times, locations of the incident(s).  If you suspect a violation of an Ogden Jr Mustang Policy, Utah Amateur Hockey Association Policy, a USA Hockey conduct policy indicate the policy violation. Provide names and contact information of those involved in the reported incident(s) or grievance.  Be very specific. *
If more space is needed, continue here.  If there is a separate incident, report it on a new form.
Full Names of Persons who are involved in the incident including their contact information if not already provided.
If you reported this incident(s) previously, indicate the date of the previous report, names of persons or entities that took the report.
Describe what has been done to resolve this issue already.
If you are requesting a specific action be taken, please describe the action and rationale for the action. 
If there is any other information you'd like to provide, please do so here.
A copy of your responses will be emailed to .
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