Speak up for health protections and keep our community safe
Use this form to let us know what’s happening with your job and your workplace. We will do our best to follow up on all responses, but please understand that we have to prioritize the most serious threats to worker or public safety.
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Employer
Work Location
Is your concern about a situation that requires immediate intervention to protect worker or public safety?
Yes
No
I'm not sure
Is your concern about racism or discrimination related to the coronavirus outbreak?
Yes
No
I'm not sure
Please describe your question or concern about safety or other issues related to the coronavirus outbreak:
Would you like someone to follow up with you directly
Yes
No
Submit
Should be Empty: