The "Unsafe Condition Reporting Program" is a proactive way to help reduce future incidents, accidents or injuries. If you see something you think may be unsafe on the UAF campus or remote campus locations, please take time to fill out this form and send it to EHSRM. You can either print the form and mail to PO Box 758145, fax to 474-5489, or simply fill out the form on the web and it will be sent automatically to EHSRM.
We require you contact information to ensure the unsafe condition is dealt with in a prompt manner. Anonymous reporting can result in delays collecting information and ensuring the reported is apprised on the status of any corrective action. Your concerns are important to us. If you would rather not provide your contact information on this report, we encourage you to instead contact one of our safety officers directly. Gary Beaudette (474-2763) or Kim Knudsen (474-5476) will personally act on your concern without identifying you. Remember, you are protected by law against personal reprisal for reporting a safety concern. We appreciate your assistance in reporting unsafe conditions.
DO NOT USE THIS FORM TO REPORT UNSAFE ICE/SNOW CONDITIONS ON WALKWAYS/PARKING LOTS. INSTEAD, CONTACT FACILITIES SERVICES AT 474-7000 OR firstname.lastname@example.org
DO NOT USE THIS FORM TO REPORT AN EMERGENCY OR AN IMMEDIATE LIFE THREATENING HAZARD. For immediate emergencies call UAF Emergency Dispatch Center emergencies at (907)474-7721.
DO NOT USE THIS FORM TO REPORT AN INJURY OR ILLNESS SUSTAINED ON THE JOB. INSTEAD USE:
Accident/Incident Reporting Form For UAF faculty, staff, and student employees
System Office of Risk Services Incident Report Form For students, visitors, volunteers, or other