Safety Notification Report Form

      Fire/Safety Information

The Safety Office is charged with the responsibility of conducting periodic inspections of the BYU-Idaho campus and conveying safety information to respective faculty members or staff employees.  This report is intended to help enhance safety awareness and is used at the discretion of the recipient.

Person Notified: Telephone:
Department Name:
Email Address: 
Safety Issue:: 
Date of Observation: Time of Observation:

Location of Safety Issue: 
Room:  Building Name: 
Location/area outside of a building:

Description of Safety Issue:

Applicable Regulation/s:

Suggested Corrective Measures:

Additional information, if any:

Safety Officer:             Phone: