Illinois OSHA Safety and Health Complaint Form

 Notice of Alleged Safety or Health Hazards Form

 For the Illinois Public Sector

This condition has been brought to the attention of: (Choose all that apply) Required
Please indicate your desire: RequiredThe OSHA Act gives complainants the right to request that their names not be revealed to their employer. Providing your name and address will only allow Illinois OSHA staff to communicate with you regarding your complaint
I am a(n): Required