FILE A WORKPLACE COMPLAINT

You can file a complaint if you believe conditions in a workplace are unsafe or if you or someone else is experiencing harassment or violence on the job and believe your employer is not correcting the situation.

Before you report your situation, you can:

  • discuss your concerns with your supervisor or employer
  • consult your joint health and safety committee member or OSH OFFICER, if there is one

One of the main purposes of the RA 11058 or Occupational Safety and Health Law is to enable a strong internal responsibility system in the workplace, which gives everyone in the workplace a role to play in keeping workplaces safe and healthy. Health and safety issues should be discussed with the health and safety committee or OSH OFFICER, if there is one. If the situation continues after you’ve tried to discuss your concerns, you can file a complaint through the SAFE FILMING PROGRAM.
 

Instructions

Complete and submit this form to file a complaint with the SAFE FILMING PROGRAM about a workplace health and safety concern. Note: We monitor online submissions only during business hours. SAFE FILMING responds to health and safety complaints submitted through this form during business hours, Monday to Friday from 8:30 a.m to 5:00 p.m, excluding holidays.

What if you need help right away? If this is an emergency call 911 immediately.

If the identified issue or hazard poses an immediate threat to the health and safety of a worker, please call DOLE HOTLINE instead of completing this form. DOLE 24/7 HOTLINE 1349.

 

Workplace Complaint Form

Fields marked with an asterisk (*) are mandatory.

Section 1 - Workplace information

WORKPLACE LOCATION

Is there a street address?
Section 2 - Complaint type
Is your complaint about workplace harassment ?
Is your complaint about workplace violence?
Section 3 - Complaint reporting
Have you reported your workplace health and safety concerns to a supervisor or your employer?
Have you reported your concerns to the health and safety committee or OSH OFFICER at your workplace?
Section 4 - Description of complaint

Please provide specific details about the workplace health and safety hazards or issues you have identified. For example:

  • If you have concerns about equipment, what type of equipment is it?
  • Is the equipment used in a particular part of the workplace or for a particular process?
  • Why do you believe this equipment or situation is unsafe or breaks the law?
  • How were you harassed or what violence took place in the workplace?

Please do not provide more personal information than is necessary to describe the complaint. For example, don’t give the name of someone you believe is harassing you, but use words such as my boss, a supervisor, a co-worker, etc. (You can enter a maximum of 2,500 characters)

Section 5 - Confidentiality

While SAFE FILMING will handle your concern with absolute discretion and will not give your name to anyone in your workplace, we cannot guarantee that your employer won’t guess that you are the complainant. We also cannot guarantee that you will remain anonymous if there is a prosecution.

If your complaint is about workplace harassment :
If you wish to remain anonymous, the investigation of your complaint will be limited to determining if your employer is complying with the workplace harassment policy, program, information and instruction requirements. They cannot investigate to see if your employer is meeting their duty to investigate harassment if you wish to remain anonymous to your workplace. The reason is that the inspector may have to release your name and the details of the complaint in order to find out whether your employer is investigating.

Section 6 - Contact information

Ways we can reach you (must provide at least one)

After you submit your complaint we will send you an email with a confirmation number if you provided an email address. This email will not include a copy of the information submitted on this form.

We may be in contact with you if we need more information about your complaint.

Please do not file another complaint to provide additional information. You can call the DOLE CALL CENTER at 1349 to ask about your complaint or provide additional information.

Privacy of information
Personal information on this form is collected for the administration of the RA 11058 or Occupational Safety and Health Law. This personal information will be used by the to be able to respond to your complaint and may be used to contact you should we require further information or clarification regarding the submitted information.