ADOSH - Complaint Forms

Arizona Division of Occupational Safety and Health (ADOSH)

Jessie Atencio, Director
Email: [email protected]

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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)