Whistleblower Complaint Form

Form Template

Filing a complaint should be easy.

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That's why OSHA accepts whistleblower complaints from employees in a variety of formats: orally (telephone or walk-in) or in writing, and in any language. Employees are encouraged to complete the app as completely and accurately as possible. Briefly describe each allegation of the whistleblower retaliation (what happened?). If there is any evidence that supports your allegation, include the information in your description.

After you have completed the Whistleblower Complaint Form mobile app, you may submit it to your local OSHA office by mail, fax, or hand-delivery. After you submit this form to OSHA, an OSHA representative will contact you about action that can be taken or opening an investigation or case, if the situation calls for it. All information contained in this whistleblower complaint will be shared with the employer.

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