Afmc Form 913 PDF Details

The Air Force Medical Service (AFMS) provides healthcare services to active duty and retired military members, their families and beneficiaries. They also provide healthcare services to Department of Defense civilians and other eligible beneficiaries. The AFMS is made up of the Medical Corps, Nurse Corps, Dental Corps, Veterinary Corps, Medical Service Corps and Health Services Management Agency. Their mission is to deliver health services that are responsive to the needs of the Total Force. In order to do this, they have a number of core values that they adhere to which are: excellence in patient care, commitment to service, respect for others, integrity and accountability. One way that they ensure excellence in patient care is by using the Afmc Form 913. This form is used by healthcare

QuestionAnswer
Form NameAfmc Form 913
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesafmc 2019 application form, standard grievance, afmc form913, afmc bds 2019 application form

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STANDARD GRIEVANCE FORM

PART I

(To be completed by employee prior to Step I)

Do you hereby request to consult with a union steward concerning this issue?

cYES

cNO

Union Case Number

Complaint

Employee Org/Duty Phone

Employee Name Printed

Employee Signature

Date

PART II

(To be completed by supervisor prior to Step I)

Supervisor Name Printed

Signature of Supervisor to Verify Receipt

Supervisor Duty Phone

Date of Receipt

Date Sent to Union

Date Sent to DMO

PART III

RECORD OF GRIEVANCE STEP I

Prior to the beginning of the Step I meeting, the employee will sign Part III.a., affirmatively electing Negotiated Grievance Procedure. Prior to the end of the Step I meeting, the grievant or the union representative, will complete Part III.b. through e., of this form and return it to the DMO. The DMO will provide a receipted copy of the updated form to the grievant and Union Representative prior to adjourning the Step I meeting.

III.a. It is understood by the parties that upon initiation of discussion of the grievance at Step I, the employee has affirmatively elected to use the Negotiated Grievance Procedure versus any other available statutory procedure.

EMPLOYEE SIGNATURE:

III.b. BRIEFLY DESCRIBE THE INCIDENT CAUSING THE GRIEVANCE (Include date, time, and place, management officials involved, and witnesses if any. If more space is needed, use separate sheet of paper.)

□SEE ATTACHMENT

III.c. IDENTIFY ARTICLE(S) OR SECTION(S) OF THE MASTER LABOR AGREEMENT, LOCAL SUPPLEMENT, REGULATION, OR LAW ALLEGED TO HAVE BEEN VIOLATED.

□ SEE ATTACHMENT

III.d. IDENTIFY THE REMEDY YOU SEEK.

□SEE ATTACHMENT

IIIe. ADDRESS (INCLUDE BUILDING NUMBER AND PHONE NUMBER):

1. Grievant

2. Union Representative

 

 

PART IV

(To be completed by the DMO at the conclusion of the Step 1 meeting and provided to the grievant/union)

THIS IS TO CERTIFY THAT THE STEP I GRIEVANCE MEETING WAS HELD ON

Date

Time

Management Official Signature

AFMC FORM 913, 2012

PART V

STEP I DECISION

 

 

 

 

 

□ SEE ATTACHMENT

 

 

 

 

 

 

 

Printed Name & Signature of DMO

 

Date

Date Provided to Union/Employee

 

 

 

 

If your grievance is not resolved to your satisfaction, you may submit the grievance to the next step of the grievance procedure by signing and dating this form below. Attach any additional information you believe is pertinent. No new issues shall be raised at this Step.

PART VI

(To be completed by grievant or representative prior to Step II)

 

 

 

Do you request a meeting at Step II?

 

Signature of Grievant or Representative (Printed Name & Signature)

 

 

Date

□ YES □ NO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART VII

 

(To be completed by Labor & Employee Relations)

 

 

 

 

 

 

Date Received by Labor & Employee Relations:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PART VIII

 

STEP II DECISION

 

 

 

 

 

 

 

 

 

 

□ SEE ATTACHMENT

 

 

 

 

 

 

 

 

 

 

 

Printed Name & Signature of Commander or Designee

 

Date

Date Provided to Union/Employee

 

 

 

 

 

 

 

AFMC FORM 913, 2012

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1. The afmc bds 2019 application form involves certain information to be typed in. Be sure that the subsequent blanks are finalized:

The best ways to fill in i grievance ii part 1

2. Once this array of fields is done, you'll want to insert the necessary specifics in IIIb BRIEFLY DESCRIBE THE INCIDENT, SEE ATTACHMENT, IIIc IDENTIFY ARTICLES OR SECTIONS, SEE ATTACHMENT, IIId IDENTIFY THE REMEDY YOU SEEK, and SEE ATTACHMENT in order to proceed to the third part.

i grievance ii completion process outlined (step 2)

3. Completing SEE ATTACHMENT, IIIe ADDRESS INCLUDE BUILDING, Grievant, Union Representative, PART IV To be completed by the DMO, THIS IS TO CERTIFY THAT THE STEP I, Date, Time, Management Official Signature, and AFMC FORM is essential for the next step, make sure to fill them out in their entirety. Don't miss any details!

Best ways to fill in i grievance ii stage 3

4. To move onward, the next section requires completing several form blanks. These include PART V STEP I DECISION SEE, Printed Name Signature of DMO, Date, Date Provided to UnionEmployee, and If your grievance is not resolved, which you'll find key to moving forward with this particular document.

Date Provided to UnionEmployee, PART V STEP I DECISION SEE, and Printed Name Signature of DMO inside i grievance ii

5. This final notch to finish this document is crucial. Ensure you fill out the necessary fields, including PART VIII STEP II DECISION SEE, Printed Name Signature of, Date, Date Provided to UnionEmployee, and AFMC FORM , prior to using the pdf. Or else, it could generate a flawed and possibly nonvalid paper!

i grievance ii conclusion process outlined (step 5)

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