ADOSH - Complaint Forms

Arizona Division of Occupational Safety and Health (ADOSH)

Brian Hudson, Director

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

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.


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)