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State of Hawaii Department of Labor and Industrial Relations HAWAII OCCUPATIONAL SAFETY AND HEALTH DIVISION 830 PUNCHEON STREET, ROOM 423 HONOLULU, HI 96813 Phone: (808) 5869110 Fax: (808) 5869104
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To fill out the Hawaii Occupational Safety and Health Notice of Alleged Safety or Health Hazards form, follow these steps:
02
Begin by downloading the form from the official Hawaii Occupational Safety and Health Division website.
03
Fill in the details of the employer, including the name, address, and contact information.
04
Provide your own personal details, such as your name, address, and contact information.
05
Specify the date and time of the alleged safety or health hazard occurrence.
06
Describe the alleged safety or health hazard in detail, including the location and nature of the hazard.
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Explain any known injuries or illnesses resulting from the hazard, if applicable.
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Attach any supporting documents or evidence related to the alleged hazard, if available.
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Sign and date the form to certify the accuracy of the information provided.
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Submit the completed form to the Hawaii Occupational Safety and Health Division either by mail or in person.

Who needs hawaii occupational safety and?

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Anyone who has witnessed or experienced a safety or health hazard in the workplace in Hawaii may need to fill out the Hawaii Occupational Safety and Health Notice of Alleged Safety or Health Hazards form.
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This includes employees, contractors, visitors, or any individual who wishes to report a potential safety or health violation in a Hawaii workplace.
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Hawaii Occupational Safety and Health (HIOSH) is the state agency responsible for ensuring safe and healthy working conditions for employees in Hawaii.
All employers in Hawaii are required to file Hawaii Occupational Safety and Health reports.
Employers can fill out Hawaii Occupational Safety and Health reports online by visiting the HIOSH website and following the instructions provided.
The purpose of Hawaii Occupational Safety and Health is to prevent workplace injuries and illnesses by promoting safe and healthy working conditions for employees.
Employers must report information such as workplace injuries, illnesses, and safety violations on Hawaii Occupational Safety and Health reports.
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