Page 14 - Construction Forms

TM

Event Register

All accidents & near miss incidents (Events) are to be recorded no matter how insignificant they may appear at the
time. If you are not sure whether to record an event or if it is notifiable, please ask your supervisor. If an event causes
death or injury (harm), follow the Emergency Plan, administer first aid & contact the appropriate emergency services &
call WorkSafe. If you are not sure, please contact HazardCo for assistance on 0800 555 339.

Date: Event (Accident/Incident):

HazardCo Contacted: WorkSafe NZ Contacted: Notifiable Event:
(0800 555 339) (0800 030 040)
Yes No
Yes No Yes No Discussed at H&S Meeting:
First Aid Provided:
Event (Accident/Incident): Yes No
Investigation Completed:
Yes No

Date:

HazardCo Contacted: WorkSafe NZ Contacted: Notifiable Event:
(0800 555 339) (0800 030 040)
Yes No
Yes No Yes No Discussed at H&S Meeting:
First Aid Provided:
Event (Accident/Incident): Yes No
Investigation Completed:
Yes No

Date:

HazardCo Contacted: WorkSafe NZ Contacted:
(0800 555 339) (0800 030 040)

Yes No Yes No
First Aid Provided:
Notifiable Event:
Investigation Completed:
Yes No Yes No
Discussed at H&S Meeting:

Yes No