Report a Safety Concern


Report a Safety Concern to Environment, Health & Safety (EH&S)

Use this form to report health, safety, or environmental issues or a non-employee injury at UC San Diego.

 

Name:  

Department:  

Phone:  

E-mail (required):  

   

Date of incident:  

Time of incident:  

Where (be specific):  

What is the problem?  

What changes would you recommend
to correct the unsafe condition?		  

Have you informed your supervisor?

  Yes   No