KNOWLEDGE BASE
FORM
Workplace Incident Report Form
Document No:
FORM-002
Version:
1.0
Approved by:
Management
Effective Date:
30/06/2026
Review Date:
20/06/2027
Purpose
The Workplace Incident Report Form is used to document workplace incidents involving employees, contractors, students or visitors. Recording incidents promptly supports appropriate investigation, corrective action and continuous improvement, helping to reduce the likelihood of similar incidents occurring in the future.
Management is responsible for maintaining the Workplace Incident Report Form. Completed forms are stored within the organisation's governance records and are reviewed periodically, following reported incidents where appropriate, and as part of workplace health and safety review activities. All employees are responsible for reporting workplace incidents and completing this form as soon as practicable after an incident occurs.
When is this form used?
This form should be completed whenever a workplace incident occurs involving an employee, contractor, student or visitor.
Examples include:
Work-related injuries or illness
Near misses
Slips, trips or falls
Manual handling injuries
Equipment-related incidents
Property damage
Aggressive or abusive behaviour
Exposure to blood or bodily fluids
Security incidents
Any other event that results in, or has the potential to result in, injury, illness or damage
Where immediate medical attention or emergency assistance is required, this should always take priority over completing the form.
Completing the Form
Provide as much information as possible to assist with incident investigation and follow-up.
Include:
The date, time and location of the incident
The people involved
A description of what occurred
Any injuries sustained
Immediate actions taken
Witnesses, where applicable
Recommendations or suggested corrective actions, if known
Management will review the incident, determine whether further investigation is required and implement any appropriate corrective actions.