Report a Safety Concern

Use this form to tell the Masis safety team about a hazard, near miss, or other safety concern at a worksite. Every report is reviewed. You do not have to give your name.

About anonymous reports. If you choose "Yes" to question 1, we do not record your name or contact details, and this site does not log your IP address, browser, or location alongside your report. That also means we will have no way to reach you for follow-up questions.
Retaliation against a worker for raising a safety concern is prohibited by law (OSHA whistleblower protections).

1. Are you submitting this report anonymously? *

Yes — do not record who I am No — I am willing to be contacted

2. Your name (optional)

3. A phone number or email address (optional)

4. Client company / worksite location * Example: "ABC Manufacturing – Worcester, MA" — the site where the concern is.

Which Masis branch are you working through? (optional) Helps us get this to the right branch. Leave it blank if you are not sure.

5. What is the nature of your concern? *

Safety Hazard Near Miss Injury / Illness Concern Equipment Issue Training Issue PPE Concern OSHA Compliance Concern Other

Please describe the type of concern

6. Please describe the concern. * Example: "Forklift operators are driving through pedestrian walkways without warning signals."

7. Where is the concern located? * Example: "Shipping Department near loading dock #3."

8. When did you observe the concern? *

Today Within the Past Week Within the Past Month Ongoing Condition Other

Please tell us when

9. Has the concern been reported to anyone at the worksite? *

Yes No Not Sure

Who was notified?

10. Do you believe there is an immediate risk of serious injury? *

Yes No Unsure

11. Additional information (optional)

12. Upload a supporting photo or document (optional) Photos, screenshots, or documents. Up to 5 files, 10 MB each. Accepted: .jpg, .jpeg, .png, .gif, .webp, .heic, .pdf, .txt, .doc, .docx

Questions marked * are required.