Online Form Submission

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Disclosure Agreement
Step
Participant Information
Step
Consent

Privacy Agreement

All individuals present at the hearing must sign the privacy agreement, including, but not limited to, parties, their representatives, interpreters, observers and witnesses.

If you are a representative, you are responsible for ensuring that the Appeals Commission receives the completed agreements from you, your client, and any witnesses or observers attending the hearing with you.

If you are self-represented, please continue to the next pages to complete the agreement.

ATTENTION: Once you begin, you will NOT be able to save the information and come back to submit it later. It will not save or be submitted until you click the SUBMIT button.

Please make sure you have the items below before starting :

claim number; and
the date and time of hearing.

Do you wish to proceed?

Claim and Hearing Information

Claim Number(s):

Hearing Date:

Hearing Time:

Hearing Method:

Teleconference

Video Conference

Participant Information:

Last Name:

First Name:

Email Address:

Consent to Protect Appeals Commission Proceedings and Privacy

To protect the integrity of Appeals Commission proceedings and the privacy of all individuals participating, I undertake and agree not to photograph, video or audio record or rebroadcast any part of the hearing in any form.

I understand that if I photograph, record or rebroadcast any part of the hearing, the Appeals Commission may take legal action against me.

I agree