Reporting Accidents, Illnesses, Incidents, or Hazards.

Use the information below to select the appropriate form for reporting accidents and potential hazards.

Near Miss or Potential Hazard

Use this web form to report a near miss that could easily have resulted in injury or property damage. Also to report hazards that could potentially result in injury, illness, or property damage. Examples are unsafe conditions, unsafe behaviors, improper equipment use, or unsafe equipment.

This form may be used to anonymously report concerns. If using the e-form version simply leave the email field blank.

A PDF version of this form can be downloaded here.

Do not use this form to report incidents listed below.

Accidental Injury/Occupational Illness

Use this web form to report incidents or conditions which result in injury or illness, motor vehicle accidents, or property damage.

A PDF version of this form can be downloaded here.


If you have any questions about which form you should use, or if you prefer to report by phone or email please contact EHS at (360) 650-3064 or

Page Updated 11.22.2017