Online Form - Hazard Report Form - Section One

Please complete the form below. A copy will be sent to your email address to be forwarded to your direct supervisor for completion of Section Two.  A copy of this report will also be emailed to immediately after completion. If you have any questions, please contact Safety & Wellbeing Officer Lynsey Gannon on 08 9168 4100 or

Section one

This section is to be completed by person report the hazard

Employment type *
Potential hazard impact *

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