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)