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Hazard Report Form (This template is a guide and should reflect your own individual business needs)Date: Reported By:Name: Position: Reported To:Name: Position: Site Location: Subject: Incident Near.

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physical - radiation, magnetic fields, pressure extremes (high pressure or vacuum), noise, etc., psychosocial - stress, violence, etc., safety - slipping/tripping hazards, inappropriate machine guarding, equipment malfunctions or breakdowns.

reporting the issue verbally to your supervisor or manager. reporting the issue through the workplace's hazard reporting procedures. raising the issue with the health and safety representative. raising the issue with management through your union representative.

Use a hazard/incident report form to help your workers report health and safety hazards and incidents. Keep a training register to record and sign off on all training completed by your workers. Keep a training register to record and sign off on all training completed by your workers.

Identify the incident / hazard type and the level of treatment needed. Record who was injured, their contact number, and the nature of the injury. Document the task/s performed when the incident / injury occurred. Check which factors contributed to the hazard, incident, and/or injury.

Identify potential hazards, provide a description, and determine the risk rating depending on the hazard's severity. Take or attach a photo of the hazard (if possible) Add notes or comments where necessary.

When you must notify SafeWork NSW about an incident, death or illness at work. A 'notifiable incident' under the work health and safety legislation relates to: the death of a person. a serious injury or illness of a person. a potentially dangerous incident.

A hazard report form is the document used to ensure that appropriate actions are taken to prevent the hazard from turning into an incident - and also acts as the formal record of that hazard. ... Hazard report forms are often the first line of defence used by the people on the front lines - site workers.

Brief description of hazard/incident: (Describe the task, equipment, tools and people involved. Use sketches, if necessary. Include any action taken to ensure the safety of those who may be affected.) Where is the hazard located in the workplace?

Keep track of when and where the hazard was reported. Describe the hazard using text, images, and annotations. Determine the seriousness of the injury and the medical attention required. Create a corrective action plan to minimize hazard risk. Implement control measures for accident prevention.

Introduce the Purpose of the Safety Report. ... Include Clear, Labeled Diagrams. ... Include All Relevant Statistics. ... Write Out All Steps Clearly. ... Use Clear, Simple Language.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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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
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
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 workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
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