Health and Safety Report Form

Name

First Name

Last Name

Phone

(###)

###

####

Email

Employer (if retail include store #)

Are there any health and safety concerns you would like to report to your union?

Are there any health and safety supplies or protective gear missing from your work place?

Disinfecting Wipes

Hand Sanitizer

Gloves

Soap

Toilet Paper

Does your employer care about your safety?

Health and Safety are a top priority at UFCW 227. Talk to one of our experienced organizers today about how to start a union in Kentucky and Southern Indiana.

Health and Safety Report Form

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