COVID-19 Complaint

New York State has enacted various laws and regulations to protect workers in response to the COVID-19 pandemic. These laws and regulations provide benefits - including sick leave, paid family leave, and disability benefits - to New York employees impacted by mandatory or precautionary orders of quarantine or isolation due to COVID-19. They also provide workers in the public and private sectors with protection against exposure and disease during an airborne infectious disease outbreak. If your employer does not comply with these laws and regulations, you have the right to file a complaint.

Read more at https://dol.ny.gov/ny-hero-act

Complete this form to file a complaint. Your complaint will remain anonymous.

1. I am filing a complaint because:

2. title

First Name

Last Name

3. Your Phone Number (including area code)

4. Your Email This question requires a valid email address.

5. Your Employer (required) *This question is required. Business Name

6. Employer/Owner’s Name Business Name

7. Employer/Owner/Business Email Address Business Name This question requires a valid email address.

8. Business Address

Address Line 1

Address Line 2

City/Town (required) *This question is required.

State (required) *This question is required.

Zip Code This question requires a valid number format.

9. Business Phone Number (including area code)

10. Type of Business (required) *This question is required. (e.g., Retail, Restaurant, Barbershop/Salon, Government, Public School, etc.)

11. Number of Employees (required) *This question is required.

12. Are you, or were you, under an order to quarantine or isolate given by a government entity? (required) *This question is required.

13. Have you been punished, threatened, or in any way experienced retaliation for asserting your rights to a safe workplace? (required) *This question is required.

Please provide details of the retaliation. Include a timeline of events and full names and titles of all persons involved: (required) *This question is required.

14. Please describe your complaint in detail: (required) *This question is required.