Hazard Reporting Form

 

If you have identified a hazard around the UCR campus, we need to know about it! This form is not to be used for emergencies or imminent danger situations. Call 9-1-1 to report emergencies.

Please identify any unsafe conditions by completing the information below:
Your Name:
(optional)
Department:
(optional)
Phone:
(optional)
Email:
(optional)
Unsafe Condition or Practice:
*
Location:
*
Suggestion for Correction:  
     
Employees are advised that it would be illegal for an employer to take any action against an employee in reprisal for exercising rights to participate in reporting safety issues.
 

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