Report a safety concern or non-compliance

About You
Safety Concern
Responsible Party & Others Involved
Attachments
Review
Submit

If you do not want to provide your details and you want to make a report anonymously, please check the box. By not giving us your details, Energy Safe may be limited in the action we can take and you will not be kept informed.

It is helpful to provide a contact phone number should we need further information. You can still remain anonymous.

Contact phone number

About You

First name

Last name

Phone number

Address

Address Line 1

Suburb

State

Postcode

Who are you in relation to the safety concern?

Other, please specify

Please use formatting such as: A12345, REC-12345, I980123, VBA LIC 12345, D12345 (for restricted electrical licence)

Licence or registration number

Who are you acting on behalf of?

Their details

First Name

Last Name

Phone

Can they be contacted by Energy Safe?

Who is the other person in relation to the safety issue or non-compliance?

How are you related to the affected person/business?

If you are a representative of a business or organisation, please provide the name of the business or organisation

Follow up - Do you require a response from Energy Safe?

Case

Name

Report a safety concern or non-compliance

I have a safety concern that I need help with right now

About You

Who are you acting on behalf of?

Their details