Request a steward

Tell us what's going on and a steward will get back to you. Only the union sees this.

Which steward would you like? You have the right to ask for a specific steward. If they're unavailable, another one will be assigned.

About you

So a steward knows who to contact and when.

Full name

Department

Location or facility

Position or title

Mobile number *

Best time to reach you * Stewards are working their own shifts — this helps them catch you when you can actually talk.

Personal email * We contact you here, not at work.

KP email *

We keep this for our records only. We never send anything to your Kaiser address — Kaiser's mail system blocks outside senders.

Employment status

Hours

Shift start

Shift end

Shift

Days you usually work

Department Administrator (DA) *

Assistant Department Administrator (ADA) *

The situation

These answers help a steward judge how urgent this is.

Do you believe this could lead to discipline? This helps your steward understand how serious the situation may be, so they can prepare accordingly.

Has a union representative already been contacted about this? This helps us avoid opening a duplicate request.

Has management asked to meet with you?

Did they tell you what the meeting is about? Knowing this in advance helps your steward prepare specific talking points.

Did anyone mention investigation, corrective action, or policy violation?

What happened

What happened?

When did it happen?

Anything to add about the timing? (optional) If you're not sure of the exact date, or it happened more than once, say so here.

Where did this happen? The specific location or unit can matter for your case.

Who was involved or present? Full names and phone numbers if you have them.

Has this happened before? Repeated incidents can be treated differently than a one-time issue.

Do you have any documentation or messages related to this?

Were you given anything in writing? A written notice can carry different weight than a verbal conversation.

Is there a specific date or deadline you're worried about? If you were told you have until a certain date, this helps your steward move fast enough.

Is this the first time you've talked to anyone about this issue? Helps your steward know if they're starting fresh or picking up something already in motion.

Are there coworkers who saw this and would talk to a steward? Willing witnesses can help support your case.

How you're doing

Your experience of this matters, not just the facts.

How are you feeling about the situation?

Do you feel singled out or treated unfairly?

Has management spoken to you about this informally before?

Is there anything happening outside work that's affecting this situation? Totally optional — only share what feels relevant to you.

Do you believe this is connected to your race, gender, age, disability, or another protected characteristic? This can affect which laws and deadlines apply to your situation.

Is there a language you'd prefer to communicate in? Helps us match you with the right steward or arrange interpretation.

Anything to attach?

Optional. Schedules, messages, written warnings, photos.

Up to 10 files, 25 MB each.
JPG, PNG, PDF, DOC or DOCX.

Check it over

Make sure this reads the way you meant it. You can go back and change anything.

Before you send this

Everything I've written here is true and accurate to the best of my knowledge.
This request goes to SEIU-UHW stewards and representatives so they can support me, and stays within the union. A steward will talk with me before any details are raised with management.
Sending this asks for a steward — it does not file a grievance. Contract deadlines may still be running, so I'll tell my steward right away if I've been given a date or a deadline.

I've read the above and confirm it's accurate.

Request received

Your ticket number—

Steward availability During daytime work hours, stewards may be working in their departments, attending meetings, or off for the day (including vacation). If the steward you request is unavailable, an available steward will be assigned to support you. Please allow 24 hours for a steward to reach out.

Write your ticket number down — it's how we find your request.