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NSW ARCP Class BNSW Mobile Crane Safety ChecklistNSW Asbestos Clearance (No Air)NSW WHS Organisation (Form 01)NSW WHS Roles (Form 02)NSW WHS Policy (Form 03)NSW WHS Site Risk AssessmentNSW WHS SWMS (Form 05)NSW WHS Toolbox Talk Record (Form 06)NSW WHS Training Register (Form 07)NSW WHS Test and Tag (Form 08)NSW WHS Chemicals Register (Form 09)NSW WHS Incident Report (Form 10)

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Form guides

NSW WHS Incident Report (Form 10)

How to complete the Housing Industry Site Safety Pack incident and injury report in Tradie Forms.

NSW WHS Incident Report PDF preview
NSWBuilding

SafeWork NSW

Record workplace incidents and injuries for the Housing Industry Site Safety Pack and download the official SafeWork NSW PDF.

Open this form

Use this guide when you complete WHS Form 10: Incident and Injury Report from the Housing Industry Site Safety Pack in Tradie Forms.

Open the form after urgent care and immediate site safety actions have been handled.

Before you start

  • Record incidents as soon as practical after they occur.
  • For serious incidents, follow your WHS procedures and check current SafeWork NSW notification requirements.
  • Some yes/no tick boxes on the PDF are print-only. Mark those on the downloaded PDF if needed.

This report does not notify SafeWork NSW. For a death, serious injury or illness, or dangerous incident, use the current SafeWork NSW notification process immediately. Preserve the incident site except for permitted actions such as helping an injured person or making the site safe.

In the app

Injury

Enter incident date and time, nature of incident, and injured person details including name, occupation, address, date of birth, phone, and employer.

Add activity, site location, and nature of injury. Mark the body diagram on the downloaded PDF after download.

Record treatment on site, treating person, doctor or hospital, and return to work coordinator if applicable.

Witnesses

Add up to two witnesses with name and contact details.

Property Incident

If the incident involved property, plant, or environmental damage, enter date, time, location, damage details, and who received the report.

Description

Describe what happened in the description field.

Immediate Actions

Record immediate response actions taken to stabilise the situation.

Reporting

Enter details for reports to the principal contractor, authorities, and workers compensation insurer in the details fields provided.

Record the date, method, recipient and any reference number. Do not delay a required notification while completing this PDF.

Completed By

Enter name, position, signature, and date for the person completing the report.

Save injured person and completed by details as saved details on Solo or Team where helpful.

After download

  1. Check names, dates, injury details, witnesses, actions, reporting details, signature and print-only boxes.
  2. Keep the PDF with the incident, injury and investigation records.
  3. Complete any required SafeWork NSW, insurer and principal contractor notifications separately.
  4. Track corrective actions through to completion and review the relevant risk controls.

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NSW WHS Chemicals Register (Form 09)

How to complete the Housing Industry Site Safety Pack hazardous chemicals register in Tradie Forms.

QLD Form 12

How to complete Queensland Form 12 as an appointed competent person in Tradie Forms.

On this page

Before you startIn the appInjuryWitnessesProperty IncidentDescriptionImmediate ActionsReportingCompleted ByAfter download