Compliance Assistance Request Form


An employer may request a free compliance assistance activity or visit for a facility or workplace location.  This form can be used to make this request. The compliance assistance visit is purely voluntary and can be cancelled before or during the visit.   Hazards identified by the consultant will not result in citations or penalties; however, they must be fixed within an agreed upon time period.  Following the visit, the consultant will prepare a detailed report and send it to the employer electronically.

This form can be submitted online or it can be submitted to ADOSH by mail, fax, or hand-delivery.

For more information, contact ADOSH toll free at (855) 268-5251 or (602) 542-5795 (Phoenix) or (520) 628-5478 (Tucson).