Report a Safety Issue

Complete Personnel Recruitment is committed to maintaining a ZERO HARM environment for clients and on-hire employees.

You may have a safety concern at your worksite, been involved in an incident or even witnessed an incident or near miss. If so please use the online form below to make your report. Please complete as much detail as you can in the appropriate fields. The information contained within will be sent to Complete’s OHS&W Manager for follow-up.

Section A: Incident Details

Date Of Incident

Time Of Incident

Host Employers Name

Location onsite where incident occurred

Section B: Contact Details of Reporting Person

Surname

Other Names

Home Phone Number

Section C: Notification

Briefly outline the safety issue or how did the incident happen (include area and task, equipment, tools and people involved)

Name(s) of Witness(es)

Phone Witness(es)

Has Host Supervisor been advised?

Name of Hos Rep advised:

Date & Time advised:

Possible solutions / how to prevent recurrence – Do you have any suggestions for fixing the problem or preventing a recurrence?

Section D: Injury Details (if applicable)

Type of injury (e.g. burn, sprain, laceration)

Part(s) of the body affected: *

Was first aid treatment required: *

Name of person giving first aid treatment

First Aid Treatment Date

First Aid Treatment Time