Report an Incident, Concern, Question, or Idea

This form is for accidents and incidents and near misses.

Report all unsafe conditions and near misses, no matter how minor the perceived risk may seem.  This report is sent directly to the Safety Coordinator, Kali Levsen.  Kali will promptly contact you for further details of the incident or near miss and will work with you, your supervisor, EHS, and other resources to work to eliminate the unsafe conditions.  There will be no retribution for an injury or filing a near miss report.

This form is to anonymously report a safety question, concern, or idea.

Nervous about a procedure that everyone else seems to be comfortable with?  Want to make sure you're being safe but don't want to feel like a fool for asking?  Continuously see your lab mates not use PPEs and you're worried about them?  Have an idea that would bring more connection within our department?  Anything you want to anonymously say or ask about can be done through this form.  It goes directly to our Safety Coordinator.