NOTIFIABLE INCIDENT REPORT FORM - SafeWork SA - SA 2026

1. Click ‘Get Form’ to open the NOTIFIABLE INCIDENT REPORT FORM in the editor.
2. Begin by filling in the 'SERIOUS INJURY OR ILLNESS' section. Enter the date and time of the incident accurately.
3. In the 'DANGEROUS INCIDENT' section, provide specific location details, including site address, type, suburb, state, and post code.
4. Detail what work was being performed at the time of the incident and describe what happened. Include any plant used during the incident and its apparent cause.
5. Complete the 'INJURED PERSON' section with their name, occupation, address, sex, work experience, date of birth, phone number, and injuries if known.
6. Fill out the 'DETAILS OF PCBU' section with business/entity name, ABN, address, phone number, and role of PCBU.
7. Finally, complete your details in the 'NOTIFIER’S DETAILS' section before submitting your form electronically through our platform.

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