Public Sector Employee Complaint Form


If you are an employee of a state agency, county government, a municipality, or any division thereof, a water district, sewer district, school district or any other quasi-municipal agency and want to report or health violation, or believes the employer has discriminated or retaliated against you for reporting an unsafe condition, please fill out the online-form below, or download and fill out the paper form.

If you have any questions about filing a complaint or completing this form, please call 207-623-7900.


1. Please Check one: I am an Employee

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4.Your Phone:

5. Zip Code:

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7.Your Employer:

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12. Does the alleged violation threaten imminent death or serious harm? Yes

13. Has the condition been discussed with your employer and no action taken?

14. Can we use your name: DO NOT reveal my name You can use my name

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