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Industrial Commission of Arizona

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Industrial Commission of Arizona
Protection of life, health, safety, and welfare of Arizona's workforce

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  • Home
  • Agency Information
    • About Us
    • Commissioners
    • Data & Statistics
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      • Arizona Statutes
      • Arizona Rules
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      • All Public Meetings
      • Commission Meeting Agendas
      • Meeting Minutes
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    • Administration
      • Accounting
      • Human Resources, Special Services and MIS
      • Self-Insurance and Tax Office
    • Administrative Law Judge (ALJ) Division
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      • Boiler Section
      • Elevator Section
      • Occupational Safety and Health (OSHA / ADOSH)
      • Research & Statistics (BLS)
    • Claims Division
    • Labor Department
    • Legal Division
    • Medical Resource Office (MRO)
    • Special Fund Division
  • News and Events
    • Public Notices
    • News and Events
  • Resources For
    • Resources for Employees
    • Resources for Employers
    • Resources for Insurers
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  • ADOSH - Complaint Forms

ADOSH - Complaint Forms

Arizona Division of Occupational Safety and Health (ADOSH)

Jessie Atencio, Director
Email: [email protected]

Phoenix Office
800 W Washington St, Phoenix AZ 85007
(PO Box 19070, Phoenix AZ 85005-9070)
Phone: (602) 542-5795
Toll Free: (855) 268-5251
FAX: (602) 542-1614

Tucson Office
2675 East Broadway, Tucson AZ 85716

Phone: (520) 628-5478
Toll Free: (855) 268-5251
FAX: (520) 322-8008

Click for Phone List of ICA Divisions
 


Forms for Safety and Discrimination Complaints

The Arizona Division of Occupational Safety and Health provides forms to allow its constituency to report safety hazards and workplace discrimination. Simply click on a link to download the form you need. All are in Adobe PDF format unless otherwise indicated.

FORMS

Notice of Alleged Safety or Health Hazards Form (English)
Notificación de Presuntos Peligros de Seguridad y Sanidad Forma (Español)
Discrimination Complaint Form (English)
Declaración de Discriminación (Español)

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Resources for the ICA Community

Wage Information

  • 2021 AMW Statutory Max - $5,030.33 
  • 2020 AMW Statutory Max - $4,888.56 
  • 2021 Minimum Wage - $12.15 per hour  

Job Opportunities at the ICA

Job Opportunities at the ICA

Public Notices

  • 09/17/20 2021 Minimum Wage Increase
  • 07/17/20 Notice of Supplemental Fee Schedule Public Hearing
Public Notice Archive

Recent News & Events

  • 05/14/20 Adjusting COVID-19 Workers' Compensation Claims
  • 04/14/20 Governor Ducey Issues Workers' Compensation Executive Order
  • 03/27/20 March 26, 2020 Updates to the 2019/2020 Fee Schedule re E-Services, Virtual Check-Ins, and COVID-19 Testing
  • 03/25/20 The latest information about the state's response to COVID-19
  • 11/20/19 Reminder: 2020 Minimum Wage Increase
Recent News Archive

Official Website of the State of Arizona

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Contact Us:

Phoenix Office
800 W. Washington Street
Phoenix AZ 85007
602-542-4661

 

tucson map

Contact Us:

Tucson Office
2675 E. Broadway Blvd
Tucson AZ 85716
520-628-5188

 

 

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