Safety Concern Report

Please use this form to report any safety concerns you may have. If an injury or property damage has occurred, you must complete the Incident Report Form.

Examples of a safety concern would include:

  • Loose railing in a stairwell
  • Slippery patch of ice on a walkway
  • Tripping hazards in hallways
  • Lab workers not using appropriate Personal Protective Equipment
  • Anything you feel has the potential to cause harm to people, property or the environment

The University of Regina collects information under the authority of The University of Regina Act and in accordance with the Local Authority Freedom of Information and Protection of Privacy Act and the Personal Information Protection and Electronic Documents Act for purposes of the administration of the University and its programs and services. By responding to this form, you are consenting to the University of Regina using your personal information to respond to your safety concern report.

Items indicated with an (*) are required.

* First Name

* Last Name

* E-mail Address

* Re-enter your E-mail Address

* Subject

* Message

* Location of incident or safety concern:

The purpose of this form is to allow everyone on campus to do their part to keep our campus safe. It is not meant to place blame, we all know accidents can happen! But, by reporting safety concerns you can help prevent larger incidents from occurring. Please do your part to help everyone on campus enjoy a safe place to work, learn, and live!