Safety Forms

Incident Report Form

DMACC faculty, staff, and students should use this form to report incidents such as property loss, auto accidents, misconduct, physical assault, personal injury, etc.

Safety Awareness Form

DMACC Employees can now report safety concerns using a new online form. Employees fill out the first section of the form identifying their safety concern and the form is then routed via e-mail to their Provost/Dean/Supervisor and then to the Safety Officer. When the Safety Officer receives the form, DMACC employees will receive a response as to the resolution of the safety issue in a timely manner.

Contact Jay Tiefenthaler​, DMACC Director of Energy Management/Safety/Security at 515-964-6612.

Workers' Compensation Forms

To provide DMACC employees the best and most efficient medical care for workers' compensation claims, you will use these forms when you have a work-related injury.