Raise a concern form

If you have a concern about an unsafe or unhealthy work situation, you can use this form to raise your concern with WorkSafe.

COVID-19 concerns

If your concern is related to COVID-19, advice for businesses and workers is available on the COVID-19.govt.nz website. (external link)Please check there before you contact us.

To report COVID-19 compliance breaches, including managed isolation and quarantine facilities, please use the COVID-19 breach form(external link).

We have listed a series of questions you need to consider before raising a health and safety concern with us on on the raise a health and safety concern page.

Yes, I have read this information

Details about location and situation

Name of business (required)

Please enter the name of the business you have a concern about.

Location of the business or workplace (required)

Please provide the precise location of the business or work situation you have a concern about

What are you concerned about? (required)

Please provide details about the situation and the specific risks you have a concern about

Your contact details

Your name (required)

Your phone number (required)

Enter numbers only, without spaces.

Your email address (required)

Check this box if you wish your contact details to be kept confidential.

If you'd prefer to speak to someone about your concern, you can call us.

Phone 0800 030 040 (24 hours)