Use this form if you think there is a safety, supply quality or measurement problem with your energy product or appliance that Energy Safety should know about. This might include things like:
Please fill in as much of this form as possible.
If you wish to retain a copy, print the form first (use "Save as PDF") and then to send it to Energy Safety (by pressing "Submit"). Submitting the form blanks the fields.
Caution: Submitting the form blanks the fields. If you wish to print the form (from "Save as PDF") and submit it on-line you should print it first.