"In Person" Workplace Safety Report
Submit this electronic ๐—ฟ๐—ฒ๐—ฝ๐—ผ๐—ฟ๐˜ ๐—ถ๐—ณ ๐˜†๐—ผ๐˜‚ ๐—ต๐—ฎ๐˜ƒ๐—ฒ ๐—ฏ๐—ฒ๐—ฒ๐—ป ๐—ฑ๐—ถ๐—ฟ๐—ฒ๐—ฐ๐˜๐—ฒ๐—ฑ ๐˜๐—ผ ๐—ฑ๐—ผ ๐˜€๐—ผ๐—บ๐—ฒ๐˜๐—ต๐—ถ๐—ป๐—ด ๐˜‚๐—ป๐˜€๐—ฎ๐—ณ๐—ฒ at work.

Submit this electronic report if you witness direct violations of the safety requirements articulated by MMSD.

1. Report the concern to your site supervisor.
2. Contact MTI mti@madisonteachers.org or 608.257.0491
3. Complete and submit this report.

If thereโ€™s unabated health & safety violations staff should send an email to: Compliance@phmdc.com and cc: mti@madisonteachers.org for immediate action. The department will investigate the complaint followed by education of the guidelines and compliance. If the problem continues, then a citation will be served.
Your Full Name
Your personal email address
Your Job Title
Your Worksite/School/Location
What are your concerns? What COVID-19 health & safety violations occurred?
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