JAX Safety Reporting

If this is an emergency, stop filling out this form and call 911.

This page is designed to help you navigate the various ways in which we document safety concerns. In the field below where it asks why you are here, use the criteria to select an option. The form will guide you through the rest of the process.

Select “First Report of Injury” if you are a JAX employee injured on the job, a coworker who witnessed a job-site injury, or are a store manager acknowledging the injury and documenting future efforts to prevent similar injuries.

Select “Incident Report” for situations where a customer was injured, JAX property was damaged or stolen, there was a medical emergency, or where there was an incident that may need to be reported for general liability concerns.

Select “Safety Incident or Concern” if you need to document something that could cause harm to JAX employees or customers or put them at risk. You’ll have the option to select if the matter is urgent – needs to be solved within 48 hours, or not urgent – needs to be fixed but it’s not an immediate danger, or needs to be documented for future reference. This is a form that is completed to prevent incidents by identifying issues or documenting patterns.

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