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  • Whs Incident Report Form

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WHS FORM 10: INCIDENT AND INJURY REPORT Details of injury (eg to a worker or visitor) and treatment Date of incident Nature of incidentTime of incident Near missFirst aidamMedical treatment/doctorName.

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How to fill out the Whs Incident Report Form online

Completing the Whs Incident Report Form online is an essential step in documenting workplace incidents accurately. This guide provides a clear overview of each section of the form, ensuring that you can complete it with confidence and clarity.

Follow the steps to fill out the form effectively

  1. Click the ‘Get Form’ button to access the form and open it in your preferred editing tool.
  2. Enter the date of the incident. Ensure that the date is accurate and in the correct format.
  3. Provide the time of the incident, specifying whether it occurred in the morning or afternoon. Use clear indicators (am/pm).
  4. Indicate the nature of the incident, such as whether it is a near miss or an injury to a person.
  5. Fill in details of the injured person, including their name, address, occupation, date of birth, and telephone number.
  6. Document the employer of the injured person and describe the activity they were engaged in at the time of injury.
  7. Specify the exact site location where the injury occurred and describe the nature of the injury. Include specific details, such as if it was a fracture, burn, etc.
  8. Identify the body location of the injury by indicating the area on the provided diagram, if applicable.
  9. Record the treatment given on site and the name of the person who administered first aid.
  10. Specify if there was a need for further medical treatment and provide the name of the doctor or hospital, if applicable.
  11. Indicate whether a SafeWork NSW medical certificate has been received and note any injury management requirements.
  12. Notify the return to work coordinator by providing their name and other relevant details.
  13. Detail any witnesses to the incident, including their names and contact information.
  14. Complete the section for the details of the incident, including the cause and immediate response actions taken to stabilize the situation.
  15. Finish by completing your own details including your name, position, signature, and the date of completion.

Complete your report online today to ensure all necessary information is documented accurately.

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The 4 main incident reports that should be on your list are: Near Miss Reports. Near misses are events where no one was injured, but given a slight change in timing or action, someone could have been. ... Injury and Lost Time Incident Report. ... Exposure Incident Report. ... Sentinel Event Report.

Incident reports include all of the facts related to the incident, such as the contact information of the people involved; a description of the incident itself; and any follow-up actions that were taken, like medical treatment.

Incident Report Sample Walkthrough: A Step-by-Step Guide Step 1: Provide Fundamental Information. ... Step 2: Take Note of Any Damages and Injuries. ... Step 3: Identify Affected Individual(s) ... Step 4: Identify Witnesses and Take Their Statements. ... Step 5: Take Action. ... Step 6: Close Your Report.

An incident report template is a tool used to record incidents such as injuries, near misses, accidents, property damage and more. Use this template to record specific details of the incident and help organizations improve safety and security measures.

The form should include the date and time of the incident, as well as the names of all those involved. The form should also list the sequence of events, and describe any injuries and damage sustained, only the essential information of the incident happened.

Incident Report Template Identify the type of incident and provide details of person of injury, job and hazard/incident. Take or attach photo evidence of incident, environment, person(s) involved. Gather witness statements and capture digital signature. Sign off with digital signature of person reporting.

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Fill Whs Incident Report Form

Please use this form to report near-misses and assist us in preventing future incidents and making the Company a safer workplace. A work incident report is the formal documentation of specific details that describe the events of a workplace incident, such as an accident or injury. Download incident report templates in digital and PDF formats to efficiently report near misses, incidents, and accidents in your workplace. A WHS incident report is an official document, generally developed as a form, to record the key details of an incident in the workplace. Download Word document. Worker health and safety representatives may use the incident investigation form to document the investigation of incidents in the workplace.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232