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Safety Suggestion or Hazard Report Form

  1. Use this form to report any safety-related issues like hazards, difficult tasks, ideas for better or safer ways to do tasks, etc.  This form can be submitted anonymously.

  2. Please provide details of any hazard or safety concern that you have noticed.

  3. Upload any relevant photos or documentation

  4. Did you report this to a supervisor or safety committee member?
  5. What ideas or recommendations do you have that could mitigate a hazard or increase safety?

  6. (Optional)

  7. (Optional)

  8. (Optional)

  9. Would you like someone to follow up with you?

    If you want someone to follow up, please provide contact information

  10. Leave This Blank:

  11. This field is not part of the form submission.