H&S Incident/Injury & Hazard Reporting

Report Injury

Have you seen or been involved in an incident that has caused injury to a person.

Report Event

Have you seen or been involved in an incident which caused or could have caused harm to a person or damage to property / environment.

Report Near Miss

Have you seen or been involved in an event that had the potential to cause an injury, incident or property damage given a different set of circumstances?

Report Risk

Have you observed a situation or seen an object that has the potential to cause harm to a person/property/environment.

Record Observation

Record Proactive Safety Observations.

Corrective Action

Update a corrective action that you have been assigned.

Instructions: Please complete all fields with as much relevant detail as possible. Once completed, 'Save' the form and the following events will occur:
• You will be given a reference number, save or write this number down for future reference
• An email will be sent to the supervisor of the person involved in the incident

Ailment Details

The Primary Injury is the most important / critical injury to the person.
Primary Body Location Body Area Injury

Report Risk

Instructions: Please complete all fields with as much relevant detail as possible. Once completed, 'Save' the form and the following events will occur:
• You will be given a reference number, save or write this number down for future reference
• An email will be sent to your supervisor advising a form has been submitted

Report Observation

Instructions: Please complete all fields with as much relevant detail as possible. Once completed, 'Save' the form and the following events will occur:
• You will be given a reference number, save or write this number down for future reference
• An email will be sent to your supervisor advising a form has been submitted
Action Person Responsible Completion Date Status

Update / Sign Off Corrective Actions

Instructions: Please complete all fields with as much relevant detail as possible. Once completed, 'Save' the form and the following events will occur:
• An email will be sent to both responsible person who will check CA and person responsible who will take action for CA advising a form has been submitted
Title Filename Type