Report A Safety Concern

REPORT A SAFETY CONCERN

The Safety & Health Office and the Marshall University Safety Committee seek input from faculty, staff, students, and the community that identifies safety hazards, unsafe conditions, or unsafe work practices. This form may be used to submit a safety issue for consideration by the Safety & Health Office and the Safety Committee.

PLEASE NOTE: Safety Concern submissions reach the Safety & Health Office and the Safety Committee without the sender's name or e-mail address unless this information is provided.

You may also submit a written Safety Concern by mailing to:

Safety & Health Office
Sorrell Maintenance Building
One John Marshall Drive
Huntington, WV 25755

Safety Committee
c/o Human Resource Services
207 Old Main
One John Marshall Drive
Huntington, WV 25755

Thank you!

I wish to submit a .

If "Other Safety-Related Issue", please identify: .

Date this issue began: .

How long has this been an issue:

Subject:

Please enter your issue, ask your question, or make other safety-related input in the space below.

Is there an action that you recommend the Safety & Health Office or the Safety Committee take in regard to this communication?

Please indicate your status:

Would you like a reply to your Safety Issue Submission? If so, please provide your name and a daytime telephone number and/or e-mail address where we might reach you.

Name:

Phone Number:

E-mail Address:

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PLEASE NOTE: Submissions reach the Safety & Health Office and the Safety Committee without the sender's name or e-mail address unless this information is provided. By leaving these fields blank, you may provide an input anonymously. Also remember that paper mail may be sent to the address provided above.