Report • CampusOptics

Environmental Health & Safety, Georgetown University

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Reporter Info

Email Address* Required

Phone Number* Required

First Name* Required

Last Name* Required

Name* Required

Additional Location Details

Exact Location

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Did you submitted a work request to Facilities Management for your concern(s)?

Actions/repairs performed by the Facilities Management staff for your concern(s)?

Additional description of your concern(s)?

Temperature, Air Circulation

Water Issues: Water intrusion in your space (plumbing issues, roof leaks, etc.)

When did it happen?

How long were building materials wet?

Check all that apply

Odor/Smell

When did you start to notice the odor/smell?

Additional description of your concern(s)?

Are you experiencing any health concerns?

What are your symptoms? Check all that apply

How long have you been experiencing them?

Are your symptoms alleviated when you leave your office/residence?

Do you have medically diagnosed allergies? Please describe

Do you have any hobbies that may contribute to your health concerns?

Additional description of your concern(s)?

Brief description of your concern(s)

Add files to upload as supporting documentation along with your incident.