Windsor Regional Hospital

The union can only fix what we know is broken. Help us help you make a difference by making your workplace safer.

There are steps to resolving hazards which must be followed.

1. Notify your immediate supervisor
2. If unresolved, notify a member of your Joint Health and Safety Committee - the union will assist you with this by completing the form below
3. If remains unresolved, the union will assist you in reporting to the Ministry of Labour

Hazard Form

All fields are mandatory
First Name:		Last Name:
	--Select-- Email Address Phone Number
Department:		Date of Hazard:
Description of Hazard (brief)
Did you contact your supervisor/manager?		--SELECT-- Yes No
Supervisor/manager Name:
Supervisor/manager response
You must contact your supervisor before you can continue using this form!
Did you complete a ProRisk?		--SELECT-- Yes No
Please review hospital policy on reporting before continuing.