Risk Management Services

A Unit of the Business Affairs Division

Safety Hazard Form

This form is for reporting routine physical safety hazards that need attention.  Examples include broken or missing handrails, tripping hazards, fire hazards such as improper storage, or other conditions that might result in injury or property damage.  Risk Management Services will evaluate the condition reported, and coordinate any action needed with the appropriate university department.

Please complete the information requested below, including your contact information so we can reach you for more information if needed.  You may also attach a photo of the hazard to assist us in evaluating the reported hazardous condition.

DO NOT USE THIS FORM FOR INJURY REPORTING.

DO NOT USE THIS FORM FOR REPORTING URGENT OR IMMINENT HAZARDS!  

CALL 9-1-1 TO REPORT AN EMERGENCY CONDITION.

Thank you for helping to make your campus a safe and healthy environment for all!

Photo of hazardous condition is helpful but not required. Max upload size is 2MB.
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