Report an Unsafe Act

  • Title of report

Report of an Unsafe Act

  • Select date

  • What is the column location? Enter letter then number (example A12)

  • What was the event?

  • Who did you notify?

  • Please include a photo.

  • What did you do to resolve the issue?

  • Signature

  • To submit this report, press "Export" and mail to Mike Shubert (michael.shubert@volvo.com) & Ron Kline (ronald.kline@volvo.com)

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.