Accident Reporting Form

If you have had an accident while at work (in the office, working remotely or at a community venue), please complete the below form to detail when and where it happened as well as details of the incident that occurred.

This form can also be used to record any client accidents that occur in the building or within a community venue. It will be uploaded to Casebook once reviewed by the H&S representative.

Once submitted, the form will automatically be sent to the CABB Health & Safety representative who will investigate the cause of the incident and make any necessary steps to help prevent future incidents from taking place. They may, dependant on what is noted in the form, reach out to you for more information or to discuss in more detail.

Incident Details

Please complete the fields below for yourself or the person you are reporting on behalf of to detail when and what happened.

Name Of Injured Person(Required)

First Last

Date of Incident(Required)

Time of Incident(Required)

Location Of Incident(Required)

Description Of Incident(Required)

(Provide a detailed account of what happened)

Person Who Helped Information

Please detail the name of who helped and what support they provided.

Name Of Person Who Helped

(If Any)

First Last

Role Played By Person Who Helped

Email Of Person Who Helped

Contact Number Of Person Who Helped