# NSW WHS Incident Report (Form 10) (/docs/form-guides/building/nsw/nsw-safework-whs-10-incident-injury-report)



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](/forms/nsw-safework-whs-10-incident-injury-report) after urgent care and immediate site safety actions have been handled.

## Before you start [#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.

<Callout type="warn" className="docs-callout-warn my-4">
  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.
</Callout>

## In the app [#in-the-app]

<span id="injury" />

## Injury [#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.

<span id="witnesses" />

## Witnesses [#witnesses]

Add up to **two witnesses** with **name** and **contact** details.

<span id="propertyIncident" />

## Property Incident [#property-incident]

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

<span id="description" />

## Description [#description]

Describe what happened in the **description** field.

<span id="immediateActions" />

## Immediate Actions [#immediate-actions]

Record **immediate response actions** taken to stabilise the situation.

<span id="reporting" />

## Reporting [#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.

<span id="completedBy" />

## Completed By [#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.

<span id="after-export" />

### After download [#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.