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Concerns form


HSE takes all health and safety concerns seriously.  HSE will use the information you provide to assess your concern, to help us please provide as much information as you can. 

The form will only take a few minutes to complete and to make it simple, it is split into the following short sections:

  • Section A: About you - we will need your name and email address
  • Section B: Your Concern
  • Section C: Who is doing it and Where
  • Section D: Disclosure – your details will not be given out when we progress your concern, unless you give your permission.


Please note; HSE does not normally enforce the following premises types, as these are normally enforced by Local Authorities;

  • Leisure premises (non-council operated) e.g. Leisure centres, gyms, hotels, pubs/clubs/restaurants
  • Retail premises e.g. garden centres, hair & beauty parlours, petrol stations, shops, supermarkets
  • Offices (except government offices)
  • Care homes (without nursing), sheltered accommodation


For a more extensive A-Z list of premises enforcement, please see the guidance here. To assist with identifying the correct local authority for the premises, please see this link. When contacting the council, please ask for the Environmental Health Team.

 

Section A: About You

Your full name:

You must provide an answer to this question.


E-mail address: i.e. me@myprovider.co.uk

You must provide an answer to this question.


Your daytime contact number:


Your address:

You must provide an answer to this question.


Postcode:

You must provide an answer to this question.


Relating to this concern, are you;

Please select one option. You must provide an answer to this question.

 


Section B: Your Concern

What activity is causing your concern?

You must provide an answer to this question.


Tell us in as much detail as possible about your concern (Max 500 words)

You must provide an answer to this question.


Who is likely to be harmed and how many people are at risk?

You must provide an answer to this question.


How long has this been an issue?

Please select one option.

How long is the activity likely to continue?

Please select one option. You must provide an answer to this question.

Have you raised your concern locally? if so, please tell us what you did and who you have spoken to (eg employer, contractor, trade union, safety representative, local authority)

You must provide an answer to this question.


Do you have any photographs or supporting documentation?

Please select one option. You must provide an answer to this question.

Section C: Who is doing it and where?

What is the name of the company or persons carrying out the activity? Please provide contact details, contact number etc. If you do not know who is carrying out the activity, do you have any other information? eg signboards, markings etc?

You must provide an answer to this question.


Where is the activity taking place? Please provide the full address, including postcode. If postcode is not known, please provide any additional information to enable HSE to locate the work.

You must provide an answer to this question.


Who is in control of the site if different from the above? Please provide contact details, contact number etc


What type of activity goes on at this site?

Please select one option. You must provide an answer to this question.

 


The next three questions identify the local authority area where the activity is taking place.

Which country is the work activity taking place?

Please select one option. You must provide an answer to this question.