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Environmental Health and Safety - Safety Concern Report

Safety Concern Report

This form is best viewed on a desktop computer.

This form is to be used to report potential safety or occupational health hazards at Western Kentucky University.
Examples of issues to be reported on this form:

  • Potential fire hazards.
  • Slip, trip and fall hazards.
  • Improper removal and disposal of asbestos or any other hazardous waste.
  • Improper storage of hazardous materials, such as, flammables, toxic and corrosive substances
  • Failure to follow safe work practices.

Examples of issues NOT to be reported on this form:

  • Crime (please report this directly to the WKU Police or call 911 for an emergency)
  • Incidents in which an INJURY or ILLNESS has resulted.
    • For Employees (including Student Workers), please complete the Employee Accident/Near Miss Investigation Report
    • For Visitors and Students (not Student Workers) please complete the Accident Report Form for Non-Employee

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 Last Modified 3/13/17