Workplace Safety Concerns

 

Please use this form to report any workplace safety concerns you may have. Your grievance will be treated confidentially and shared only with relevant personnel responsible for addressing the issue. Please provide as much detail as possible to help us understand and address your concerns.

 

Personal Information

Name:
Employee ID:
Department:
Position:

Grievance Details

Date of Incident:

Time of Incident:

Witnesses:

Description of Incident:

Additional Information

Upload Photos (if applicable):
Select Appropriate Category: Safety Equipment Workplace Hazards Emergency Procedures Unsafe Behavior Others

Additional Comments:

I understand and agree that my information will be treated confidentially and shared only with relevant personnel.
I confirm that the information provided is accurate and complies with relevant laws and regulations.

 

Please note that submitting this form does not guarantee immediate action. The grievance reported will be thoroughly investigated, and appropriate measures will be taken to address the issue. Thank you for helping us maintain a safe workplace environment.