Submit a Safety or Health Concern
NeighborImpact Safety Committee
Date
-
Month
-
Day
Year
Date
Do you want to receive updates on this concern?
Yes
No
To receive updates, we will need to know who to contact. Please enter your name if you feel comfortable, or change your answer to "No" on the previous question.
First Name
Last Name
Type of Concern
Safety
Health
To which of the following does this concern apply?
A NeighborImpact Program
A NeighborImpact Site
A NeighborImpact Employee
The entire organization
Program
Please Select
Child Care Resources
Community Development
Development
Early Head Start
Energy Assistance
Executive
Facilities
Finance
Food Program
Front Desk
Head Start
HomeSource
Housing Stabilization
Human Resources
Information Technology
Lending
Representative Payee
Special Projects
Weatherization
Site
Please Select
Becky Johnson Center HS
Bend Empire NI Office
Bend Weatherizatization
CCR Downtown
CCR Eagle Crest
East Bend HS
Empire EHS
Healy Heights HS
La Pine Coach Road HS
La Pine EHS
La Pine Finley Butte HS
La Pine JCJ HS
La Pine NI Office
Lynch Elementary HS
Madras NI Office
Nancy's House Family Shelter
Ochoco HS
Prineville EHS
Prineville HS
Prineville NI Office
Redmond EHS
Redmond NI Office
South Bend HS
Stepping Stone Shelter
Vern Patrick HS
Walker EHS
Walker HS
Westside HS
Please describe your concern:
Please describe any solutions to the concern you want the Safety Committee to consider:
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