Workplace Safety and Health Hazards
AddThis Social Bookmark Button

Hazard Reporting Form

The following safety concern notification form is for public entity employees only. A Public entity is defined as any state or local government or any department, agency, special purpose district, or other instrumentality of one or more state or local governments.

If you are an employee of a private entity do not use this form. Click Here

If your complaint is concerning the health or sanitation of a private entity such as a restaurant do not use this form. Click Here

If you are a public employee, please continue.

Complete the following form and then use the Submit button to e-mail your safety concern to the Montana Safety and Health Bureau.

Has this condition been brought to the attention of your employer or supervisor?
Invalid Input
If no, why?
Invalid Input
   
Please give us some information about the public entity and safety concern.
Date
Invalid Input
Name of Public Entity *
Invalid Input
Type of Work *
Invalid Input
Address *
Invalid Input
City *
Invalid Input
Zip *
Invalid Input
Phone Number *
Invalid Input
Description of Safety Concern *
Invalid Input
   
Please give us some information about yourself. We must have your information to update you about actions taken regarding this notification.
Name of Complainant *
Invalid Input
Address *
Invalid Input
City *
Invalid Input
Zip *
Invalid Input
Phone Number *
Invalid Input
Email
Invalid Input
   
By checking this box I am confirming that all events and conditions given in this form are true and all information is accurate and given to the best of my knowledge.
*
Invalid Input
Invalid Input
  

Montana Whistle Blower Protection

  • 17-8-412 Prohibitions on employers -- employee remedies.
    A governmental entity or private entity may not adopt or enforce a rule, regulation, or policy preventing an employee from disclosing information to a government or law enforcement agency with regard to or from acting in furtherance of an investigation of a violation.
  • 50-71-123 Retaliation prohibited.
    A public sector employer may not retaliate against a public sector employee.

Montana Safety Statutes

Contact Information

Safety and Health Bureau
P.O. Box 1728
Helena, MT 59624-1728
Phone: (406) 444-6401
 
MT.gov