Hazard Report Form/ Safety Suggestion

The purpose of this form is to report a safety suggestion, report a hazardous condition on campus, or unsafe work practice.

You may contact the Environmental Health & Safety office via telephone at (415) 422-6464 or e-mail at murphyj@usfca.edu.

If you are reporting a crime or a life-threatening condition please contact the Department of Public Safety (415) 422-4222 or call 9-1-1.

The preferred method is to complete the following and submit the completed form to the EH&S Office. The form will provide us the information we require to start an investigation into your concern and determine whether mitigation is needed.

You may submit this form without fear of reprisal and/or anonymously. If you wish to do so, you may submit the form without filling in your personal information at the bottom.

Safety concerns should first be addressed with your supervisor. If you are a student, contact your professor or any nearby staff. If you are a non-affiliate, please notify any nearby staff or faculty. If any of these parties are unable to assist, contact EH&S.

Important: Please do not use the Hazard form to report incidents, injuries, or illnesses. These require greater detail and can be reported on the Incident Report form.

Please select the DATE and TIME the hazard was observed

On which CAMPUS is the hazard located?

In which BUILDING is the hazard located?

In which ROOM/AREA is the hazard located?

Describe the hazard

Please state any additional information or opinions

What is your NAME?

What is your EMAIL?

What is your PHONE NUMBER?

What is your DEPARTMENT? If you are not affiliated with any departments on campus, what is your RELATIONSHIP to USF? (ex. contractor, volunteer, student, passerby, etc.)