Global Utilities

Incident and Hazard Reporting - La Trobe University

Report New Incident or Hazard

Please complete details and click the Submit button.

Attachments can be uploaded on next screen after Submit

Fields marked with a ' * ' are mandatory.

This form is for external submissions, if you are a Student or Staff member of La Trobe University please fill in the report after logging in here.

Incident / Hazard Details
  1. Type: *
  1. : Enter time incident occurred, if known
  2. Include exact location and type of premises ( /250 characters)
  1. What were you doing at the time? How did the incident occur? Describe the hazard (/250 characters)
  1. Minimal - Basic First Aid / Minor asset damage
    Minor - Medical attention / Moderate asset damage
    Moderate - Serious injury / asset destroyed
    Major - Fatality / critical assets unusable for weeks
    Catastropic - Multiple fatalities / critical assets destroyed
Report Submitter Details
Injured Person Details
  1. Did the Incident cause an injury to any person? *
Injured person personal details
  1. Are you the injured person? Clicking 'Yes' copies the identity data specified above
  1. Injured Staff Email Address:
  1. Gender Identity: *
  2. --
Injured person contact details
Injury details
  1. (/ 250 characters)
  1. Please note: if first aid has been administered a hard-copy of the Record of Treatment must be kept in the department for 7 years.
  1. Has a First Aid Record of Treatment been completed? *

Property Damage Details
  1. Did the incident cause any property damage? *
  1. Describe the property stolen/lost/damaged (approx / 250 characters)
No Given Names Family Name Contact Phone No.

Attachments can be uploaded on next screen after Submit