Employee Concern Form
Employees:  please use this form to report any and all concerns you have about an employer’s non-compliance with the requirements of the Orange County Living Wage Employer Certification program.

Once you hit the "send" button, an email will be sent to the Orange County Living Wage team with the information you provide below.  

If you wish to anonymously report your concern, do not provide contact information below. However, it is helpful for Orange County Living Wage to be able to communicate with you directly and report back after the review is completed. If you provide contact information below, we may clarify issues with you before we discuss the matter with the named employer.

To allow us to contact you while you remain anonymous, obtain an anonymous email address for free from a service like Gmail (https://www.google.com/gmail/about/) and enter that email address below.

If 90 days have passed since you submitted  your concern and you still believe that an employer is not following the practices set out in our Orange County Living Wage Employer Certification program, please email us again.

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Name of Employer *
Nature of Your Concern *
Your Contact Info
(If Desired)
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