Make A Report

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Use the form below to confidentially report unsafe or criminal behavior at any time, day or night related to county employee safety. 

You are not required to reveal your identity unless you would like to assist with the county's review.

Reportable information will be forwarded in a timely manner to a pre-designated county official for review. Thank you for using StayALERT!

WHEN YOU ARE FINISHED, CLICK THE SUBMIT BUTTON AT THE BOTTOM OF THE FORM.

IMPORTANT NOTE: Your county must participate in the StayALERT program in order to submit a report. To confirm if your county is a StayALERT participant, please contact admin@stayalert.info

StayALERT REPORT:

County:*
Work Department: *
Specific location of incident:
Type of incident you are reporting:*
Date of incident:
Time of incident:
 : 
Name(s) of witness(es) who saw the incident taking place:
DESCRIPTION OF INCIDENT: (Please provide as much information as possible about the incident)*
Attach a photo (max. 20 MB) to include with your report:

Providing your identity and contact information is strictly optional but may be required in order to adequately respond to your report; please note that response to your report may be limited without this information. 

Would you like to remain anonymous? *
Your Name:
Phone Number:
E-mail: