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Click ‘Get Form’ to open WHS Form 10 in the editor.
Begin by entering the details of the injury, including the name of the injured person, their address, occupation, and date of birth. This information is crucial for accurate reporting.
Fill in the date and time of the incident, specifying whether it was a near miss. Be sure to describe the nature of the incident and any immediate first aid provided.
Indicate the exact site location where the injury occurred and detail the nature and body location of the injury using our platform's diagram feature for clarity.
Complete sections regarding treatment given on-site, referral for further treatment, and whether a SafeWork NSW medical certificate has been received.
Document witness information by entering their names and contact details. Ensure each witness can provide an account of what happened.
Finally, complete details about any property damage or environmental impact related to the incident, including immediate response actions taken.

Start filling out WHS Form 10 online for free today!

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Versions	Form popularity	Fillable & printable
2017	4.3 Satisfied (33 Votes)
2013	4 Satisfied (55 Votes)

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