Hazard, Near Miss & Incident Report

Report anything unsafe as soon as it happens. For serious injuries call 000 first, then notify the site supervisor immediately.

What are you reporting? *

Your full name *

Your mobile number *

Employer / company

Site *

Site address, job name or job number

Where on site did it happen?

When did it happen?

What happened? *

What was done straight away to make it safe?

How serious is it? *

Was work stopped in the area?

Photo of the hazard or area (optional)

Take a photo or choose an image (max 10MB).

Signature

Sign above with your finger or mouse

Reporting a hazard or near miss will never be held against you. Notifiable incidents must also be reported to the WHS regulator by 360 Builders — tell the supervisor immediately.