Information request

This form cannot be used to file a complaint with the CNESST. Instead, you must use our online complaints service. If you need help with this service, you can send us an information request by completing the form below and an agent will contact you so that you can file your complaint.

All fields preceded by an asterisk (*) must be filled in.

Identification

Last Name :
First Name :
* Email Address :
* Confirm Email Address :
* I am requesting information as a an :
* Business Sector :
Language :

Address

Number, Street :
Apartment, office :
* City :
Province :
Postal Code :
Home Phone Number :
Work Phone Number :
Extension :
Fax :

Information Request

* Subject :

* Information Request

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