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    iPhone, iPad

  • Android

    Android

  • Windows

    Windows Desktop

OSHA - Notice of Alleged Safety Violation Mobile App

"OSHA inspections for occupational safety can reveal health hazards and even imminent danger. This mobile app for the complainant can make work and health hazard reporting easier, using federal OSHA report standards, right from a smartphone or tablet.

This digital form, provided for the assistance of any complainant, is not intended to constitute the exclusive means by which a complaint may be registered with the U.S. Department of Labor. It is a helpful digital tool or employees, subcontractor employees and company safety officers to report occupational safety hazards in the OSHA standard, in order for company representatives to take corrective action.

Prevent physical harm with high standards of workplace safety and by reporting potential hazards. Save, share, send and document hazards with the Canvas Cloud. "


  • Lendlease
  • The Cooperative
  • PG&E
  • Toys R Us
  • Red Bull
  • Mirvac

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Take a peek inside the OSHA - Notice of Alleged Safety Violation Mobile App

Included Features

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Included Fields

Customize to add, remove, or edit any of the fields below.

  • Ico textbox First Name
  • Ico textbox Last Name
  • Ico textbox Email
  • Ico gps Current Location
  • Ico textbox Type of Business:
  • Ico multiline Site Address
  • Ico textbox Management Official:
  • Ico textbox Establishment Name
  • Ico multiline Mailing Address (if different)
  • Ico textbox Telephone
  • Ico multiline Describe briefly the hazards(s) which you believe exist.
  • Ico multiline Hazard Location Specify the particular building or worksite where the alleged violation exists:
  • Ico multiline This condition has been brought to the attention of: (Enter all that apply)
  • Ico statictext I am a(n):
  • Ico checkbox Employee
  • Ico checkbox Federal Safety and Health Committee
  • Ico checkbox Representative of Employees
  • Ico textbox Other: (specify)
  • Ico statictext The OSH Act gives complainants the right to request that their names not be revealed to their employer.
  • Ico dropdown Please indicate your desire:
  • Ico textbox Complainant name
  • Ico multiline Complainant address
  • Ico textbox Complainant telephone
  • Ico textbox Complainant email address
  • Ico textbox If you are an authorized representative of employees affected by this complaint, please state the name of the organization that you represent and your title:
  • Ico statictext Potential complainants also should keep in mind that it is unlawful to make any false statement, representation, or certification in any complaint.
  • Ico statictext Public reporting burden for this voluntary collection of information is estimated to vary from 15 to 25 minutes per response with an average of 17 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
  • Ico date Date
  • ...and More!

See it in Action

  • This form is provided for the assistance of any complainant and is not intended to constitute the exclusive means by which a complaint may be registered with the U.S. Department of Labor.
  • Android: OSHA - Notice of Alleged Safety Violation Mobile App (Example 1)
  • Android: OSHA - Notice of Alleged Safety Violation Mobile App (Example 2)
  • Android: OSHA - Notice of Alleged Safety Violation Mobile App (Example 3)
  • Android: OSHA - Notice of Alleged Safety Violation Mobile App (Example 4)

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