Hazard Hero Report
Appalachian State University campus safety hazard reporting form.
Would you like your contact information to remain confidential? *
Providing your contact information will help us better address your safety concern should we have any follow-up questions, as well as allow our office to provide you with updates. If you select yes, any contact information you provide will not be shared outside of the EHS&EM office.
Your answer
What is your affiliation to the University?
For faculty and staff only
Your answer
Your answer
Your answer
Location of the unsafe condition or act *
Include building, room number, and other specific location information.
Your answer
Date the unsafe condition or act was observed *
Please provide a detailed description of the unsafe condition or act. *
Your answer
How do you think this unsafe condition or act can be corrected?
Your answer
Have you reported this to your supervisor?
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