Report a Hazard or Liability
(IF THIS IS AN EMERGENCY DIAL 911)

Report a Hazard or Liability

*** NOTE: PLEASE USE THE WORKPLACE VIOLENCE INCIDENT REPORTING FORM TO REPORT AN ACT OR THREAT OF WORKPLACE VIOLENCE, OR OTHER WORKPLACE VIOLENCE CONCERN.***

What are you reporting?

Safety Hazard/Liability Complaint COVID-19 Hazard

Date of Incident:

Your Name:

Phone Number:

Unit, Department, School, Division:

Email Address:

Location of Hazard (Include building, Floor, and room number).

Summary of hazard:

Has any action been taken?

Do you want to be contacted?

Yes No

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Report a Hazard or Liability(IF THIS IS AN EMERGENCY DIAL 911)

Report a Hazard or Liability
(IF THIS IS AN EMERGENCY DIAL 911)