Employee and non-employee incident report

For life-threatening incidents, please call 911 immediately.

For immediate assistance, contact Environmental Health and Safety at 480-965-1823 during normal business hours. Outside of business hours, please call the ASU Police Department at 480-965-3465 and ask for EHS assistance.

If your incident involves an elevator, immediately contact Facilities Development and Management at 480-965-3633.

Submitting a report

Employee injuries. All employee and student-employee injuries or near misses must be reported using the Safety Incident Report located in Workday.
Property damage or safety concern. For incidents involving damage to ASU property or other safety concerns, please report the incident using the form below.
Non-employee or visitor incidents. All injuries, property damage or safety concerns involving non-employees or visitors must be reported by completing the form below.

Is the individual involved in the incident an

ASU employee or student employee

Non-ASU employee | guest, student, volunteer, visitor

Date incident occurred

Time incident occurred

Location of incident

Where did the incident occur?

Name of person filling out form

Email address of the person filling out the form

Contact phone number of the person filling out the form

Name of the person involved in the incident

Email address of the person involved in the incident

Job title of person involved in the incident (if applicable)

Contact phone number of the person involved in the incident

format: xxx-xxx-xxxx

Department (if applicable)

Brief description of incident/injury