Safety Form test - Seattle Fire Fighters Union, IAFF Local 27

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Safety Complaint Form

If this is an emergency complaint/concern, please contact the SFD Health & Safety Division immediately at 206-233-5154.

Your Name(Required)

Email(Required)

Assignment(Required)

Shift(Required)

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Date you first noticed a problem(Required)

Phone(Required)

Have you discussed your safety concern/complaint with your Company Officer?(Required)

Yes

Officer's Name

Have you discussed your safety concern/complaint with your Company and/or Station Captain?(Required)

Yes

Captain's Name

Have you discussed your safety concern/complaint with your Battalion Chief?(Required)

Yes

Battalion Chief's Name

Have you discussed your safety concern/complaint with the Health & Safety Division?(Required)

Yes

Health & Safety Division Contact

Please describe in as much detail as possible how this is affecting Fire Department Safety(Required)

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