# Presentation: 213594

## U.S. Department of EnergyAlbuquerque Operations OfficeEmployee Concerns Program

- The Employee Concerns Program (ECP) is a system for both DOE federal and contractor employees to report concerns associated with environment, safety, health, security, fraud, waste, abuse, or mismanagement of DOE and contractor managed activities, or reprisal for having reported such concerns.
- DOE encourages all employees to attempt resolution through the immediate supervisor or management prior to using this program.  If resolution cannot be achieved through these channels, complete the attached form and return it to:
- Department of Energy
- Albuquerque Operations Office
- Employee Concerns Program
- Management Review Division
- P.O. Box 5400
- Albuquerque, New Mexico  87185-5400
- or fax to (505) 845-4020
- or call the ECP Hotline at 1-800-688-5713.

- Thank you for bringing this concern to our attention and taking the time to complete this form.
- Michelle Rodríguez de Varela
- Employee Concerns Program Manager
- Email: 	mrodriguez@doeal.gov
- Telephone:  	(505) 845-4935

## Employee Concerns Reporting Form

- U.S. Department of Energy
- Albuquerque Operations Office

- DOE AL recognizes that free and open expression of employee concerns is fundamental and essential to the safe and efficient operations of the Department’s mission.  Employees of the DOE and any contractor or subcontractor fulfilling the DOE’s mission have the right and responsibility to report concerns relating to the environment, safety, health, security, fraud, waste, abuse or mismanagement of Department Operations.  The DOE encourages communications between Management and employees and has a zero tolerance for harassment, intimidation, discrimination, or any acts of retaliation against an employee for expressing/identifying concerns.
**This report should not contain classified information and is subject to privacy act requirements.**

**NATURE OF CONCERN:**

- What do you believe may be the consequence(s) of your concern if it remains unresolved?
- 	PERSONAL HARM				LOSS OF JOB				     DAMAGE/LOSS OF SAFETY
- 	LOSS OF LIFE OR INJURY			PERSONAL HAZARD		    	     BREACH OF SECURITY

- Where else have you reported your concern?________________________________________
- Why did you choose this avenue to report your concern?

- LACK OF TRUST IN MANAGEMENT		FEAR OF RETALIATION
- DISSATISFACTION WITH CORRECTIVE ACTION		LACK OF RESPONSE
- OTHER________________________________________________________________

- SAFETY	     HEALTH		EEO		HUMAN RESOURCES
- QUALITY	     SECURITY		ENVIRONMENTAL	WORKPLACE VIOLENCE
- FRAUD, WASTE, ABUSE		MANAGEMENT/MISMANAGEMENT
- MULTIPLE CONCERNS		OTHER_____________________________

- Describe your concern as clearly as possible.  Discuss anything that you think is relevant.  Include what you believe caused the problem and what can be done to correct the situation.  Provide names, dates, locations, witnesses, and all
- information you think is important to this concern.  Attach additional sheets as necessary.

- Date________________ *Name or Code Word**____________________________ 	 Telephone#______________
- * Correspondence Address___________________________________________________________________________

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****OPTIONAL***
*****If reporting anonymously, use a maximum of five characters******.***