Request for Mediation Intervention

Submit details of a situation requiring Mediation intervention to the Provincial Liaison Officer by fax or e-mail using the following format.


To: Provincial Liaison Officer

Subj: Request for Mediation Intervention




  • Unit
  • Unit telephone number
  • Reservist’s rank, first and last name, decorations
  • Best telephone number to reach reservist and time
  • Date of enrolment
  • Commanding Officer’s rank, first and last name

Civilian employment:

  • Company or organization name
  • Full company or organization address, including postal code
  • Company or organization telephone number
  • Title, first and last name of employer
  • Reservist’s civilian job or function
  • Reservist’s civilian hiring date
  • If the reservist is represented by a union or other bargaining unit, the name of the bargaining unit, a contact name and a telephone number

A completed privacy waiver is attached.

Full explanation of the situation requiring intervention through CFLC’s Mediation Program. Present situation in chronological order with dates, giving full description of events, actions taken and personnel involved.

Copies of memorandums, letters of request and other support documentation are available for review by the Prov LO upon request.


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