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Unsafe Condition Report

The "Unsafe Condition Reporting Program" is a proactive way to help reduce future incidents, accidents, and injuries. If you see something unsafe on the UAF campus, please take the time to fill out this form and send it to Environmental Health, Safety, and Risk Management (EHS&RM). You can either print the form and mail to PO Box 758145, or fax 474-5489, or simply fill out the form on the web and send directly to EHS&RM.

We strongly encourage you to put your name on the form, with your name we can have follow up contact with you. We can better follow up on the unsafe condition and we may have questions for you regarding what you saw, when and where.

Unsafe Condition Report

Date unsafe condition noticed : Current date:

Location (be as specific as possible):

Describe what you saw and why it is an unsafe condition:

What recommendations do you have to fix this unsafe condition?

Submitted by: Phone number:

Page last update on 12/5/07 by A.Chism