Serious Event Reporting Form

EMERGENCY NOTICE

Do Not Report an Emergency Using this Form or Email

To report an emergency, please use our VOSH Complaint form

Step 1 of 2

  • Information about the location where the incident occurred
















  • Information about the incident

  • Select date
    MM slash DD slash YYYY

  • :


  • Employer Information
















  • Information for persons who VOSH can contact

  • Contact #1







  • Contact #2