Anonymous PPE Accountability Form

It is vital that we each take personal responsibility for our own health and the health of those around us by abiding by our PPE and exposure protection standards. We should also feel empowered to hold each other accountable. If you see a staff member or physician not abiding by our policies, please mention it to your supervisor or practice administration. You can also report any concerns anonymously in the form below:

Anonymous PPE Accountability Form
  • Date Format: MM slash DD slash YYYY