Select Agent Peer Reporting Form

This form allows for reporting of incidents, behaviors and conditions that may be detrimental to a safe and secure working environment in Select Agent laboratories at UNL.

Providing contact information will aid in investigating this concern. There will be no repercussions to the reporter in response to this report; however, contact information is not required for anonymous reporting.

 
1 Start 2 Complete
Date of Incident Required
Approximate Time of Incident
:
Upload supporting document(s) You may upload social media screenshots, videos, pictures, electronic documents, etc.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png.