One recording. Multiple parts of the report.

Describe the incident, product, and contact details. Stop recording to fill the form, then review what was captured.

Record your report

Describe what happened, the product, and your contact details. Stop recording to fill the form. You can also type below.

One recording can fill multiple parts of the form.

Audio and transcripts are saved locally. Browser dictation may send audio to your browser vendor and require internet. Up to 5 minutes per recording.

Helpful phrases to use

What happened was the toaster sparked during normal use. It happened on October 12, 2026. The product is a two-slice toaster. The brand is Example. The model is AB-123. My name is Jane Doe. My email is jane dot doe at example dot com.

For an address, say “my street address is…,” “city is…,” “state is…,” “postal code is…,” and “country is…”.

What happened & the product

I am a / I am affiliated with *

I am reporting * A hazardous incidentAn incident or injury involving an unsafe product. A safety concernA product that could cause an incident or injury.

Describe the incident or safety concern *

Include how the product was used, what happened, and any injuries. Leave out names and contact details.

Review your description before continuing.0 characters

When did this happen? *This is an approximate date

Where did this happen?

Add the incident address

Street address

City

State / Province

Postal code

Country

Tell us about the product

Labels, packaging, or a receipt can help identify the product. Fill in what you know.

Product description *

Include the product name and what it is used for.

Product category

Brand name

Model name or number

Serial number

Manufacturer / Private labeler

Purchased from

Purchase dateThis is an approximate date

More product information

UPC / Barcode

Date manufactured

Manufacturer address

Do you still have the product?

Have you contacted the manufacturer?

Was the product damaged before the incident?

Was the product modified or repaired before the incident?

Photos and documents

Optional. Up to 5 JPG, PNG, WebP, or PDF files, 2 MB total. Files stay in your local draft and JSON export.

One recording. Multiple parts of the report.

Record your report

Fictional incident · read aloud while recording

What happened & the product

Tell us about the product

Your contact information

Report permissions

Review your report

Clear this draft?