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Document 5 Released under the FOR Act 1982 Edited copy s 47F (privacy) INCIDENT / HAZARD REPORT FORM INSTRUCTIONS This form has two parts. Part A must be completed for all workplace health and safety
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How to fill out incident hazard report form

How to fill out an incident hazard report form?
01
Begin by gathering all necessary information before filling out the form. This may include the date and time of the incident, location, people involved, and a detailed description of what occurred.
02
Provide your personal information, such as your name, contact details, and position within the organization. This is important for documenting who is submitting the report.
03
Clearly outline the nature of the incident or hazard. Describe what happened, including any injuries or damages that resulted. Be as specific and detailed as possible to ensure a comprehensive report.
04
Identify any contributing factors or potential causes of the incident. This could include unsafe conditions, equipment malfunctions, or human errors. Providing this information can help prevent similar incidents in the future.
05
Indicate any witnesses or individuals who may have additional information about the incident. This can be crucial for investigation or follow-up purposes.
06
If applicable, include any actions taken immediately following the incident. This could involve first aid, emergency response, or reporting the incident to relevant authorities.
07
Sign and date the form to confirm that the information provided is accurate and complete.
Who needs an incident hazard report form?
01
Organizations and businesses: Incident hazard report forms are essential for companies to document and address workplace incidents or hazards. This helps ensure the safety of employees, customers, and visitors, and allows for proper investigation and analysis.
02
Employees: Individuals should be aware of their organization's incident hazard report form and understand how to fill it out correctly. It is crucial for employees to report any incidents or hazards they witness or experience to maintain a safe working environment.
03
Safety committees or departments: These entities often play a role in reviewing and analyzing incident reports to identify patterns, trends, and potential areas for improvement in workplace safety. Incident hazard report forms are highly valuable for their work.
04
Regulatory authorities: Depending on the industry and jurisdiction, certain regulatory bodies may require organizations to submit incident hazard reports. These reports help ensure compliance with safety regulations and enable the authorities to monitor and address workplace hazards effectively.
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