Report of a Hazardous Condition or Near Miss | Central Washington University

Hazardous Condition or Near Miss

Report a hazardous condition or near miss using this form.

Full name

Field is required

Email

Field is required, and needs to be a valid email address.

Date of Occurrance

Field is required

Please use the format MM/DD/YYYY to enter the date. Example: 05/31/2024

Where did it happen?

Field is required

Describe the event

Field is required

Description of the Hazardous Condition or Near Miss