EMPLOYEE SAFETY SUGGESTION FORM Employee Name (optional): Date: Supervisor Name: CONDITION (FOR SAFETY COMMITTEE USE, If applicable) Year: Number: Suggestion Implemented? Yes as submitted Yes - with changes No – Implementation Date: Comments/Changes Made/Reason for change or not implemented:
EMPLOYEE SAFETY SUGGESTION FORM Employee Name (optional): Date: Supervisor Name: (FOR SAFETY COMMITTEE USE, If applicable) Year: Number: Suggestion Implemented? Yes – as submitted Yes - with changes No Implementation Date: Comments/Changes Made/Reason for change or not implemented: CONDITION