Complaints to the Safety and Health Committee

To file a complaint with the Safety and Health Committee, download and print the form available here.

Keep the original and make two copies. Send one copy to the Labor Relations Unit at the Dept. of Personnel, and one copy to your Field Rep at VSEA headquarters. The addresses are on the form.

The form is in PDF format, which requires the Adobe Acrobat Reader. If your web browser needs it, it's easy to download here.

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safety_and_health.pdf6.89 KB

Online State Office Building Health & Safety Issue(s) Form