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Vehicle Inspection Check In
Labour Hire Docket
SWMS
Job Safety Analysis (JSA)
Scaff Tags
Handover Certificates
Reporting page
Safety Meeting/Toolbox Record
Upload Job Photos
Management
Employee Forms
Timesheets
Leave Application
Employee Self Evaluation Form
Home
Vehicle Inspection Check In
Labour Hire Docket
SWMS
Job Safety Analysis (JSA)
Scaff Tags
Handover Certificates
Reporting page
Safety Meeting/Toolbox Record
Upload Job Photos
Management
Employee Forms
Timesheets
Leave Application
Employee Self Evaluation Form
Injury Report Form
Step
1
of
4
25%
Name of Injured Person
(Required)
Full name
Date of Injury
(Required)
DD slash MM slash YYYY
Time it occured
(Required)
Hours
:
Minutes
AM
PM
AM/PM
Where did the injury occur?
(Required)
Eg. Area onsite or part of the scaffold.
What type of injury has occurred?
(Required)
- Please select -
Broken Bones/crush injury
Sprain/Strain of joint or ligament
Bruise/swelling
Cut/Laceration/grazing
Muscular pain
Concussion
Burns
Eye injury
Multiple injuries
Specific area of body affected?
(Required)
Please give a detailed description of how the injury occured:
(Required)
How severe is the injury?
(Required)
- Please select -
Minor (notification only and no further action required)
Moderate (able to work but with reduced capacity)
Major (Unable to work and need to see a GP)
Severe (ambulance required or need to go straight to Hospital)
If the injury is visible, please upload a photo.
**This is not required if the injury cannot be seen.
Drop files here or
Select files
Max. file size: 100 MB.
Details of any witnesses to the injury:
Name of person completing this report:
(Required)
Full name
Signature
(Required)
