Hazard Report Form

This form is for anyone to report a Safety / Hazardous Violation or Safety suggestion. If you feel that something could possibly lead to a safety hazard please fill the form out and contact you supervisor and pass the information on the the Safety Officer immediately. The completed form can be campus mailed, faxed or e-mailed to the Safety Officer. Thank you for making Midwestern State University a safer place to work.

PDF Format

Please click on image to download the format you can work with. For those individuals who don't have adobe reader please go to the following site to download the Adobe Reader for free. Adobe Reader




Rich Frank/Safety Officer
Office: 940-397-4032
Fax: 940-397-4859