TEG Hazard and Incident Form

TEG Hazard and Incident Form
A Hazard is anything that has the potential to injure or harm people, property and equipment. Example: identifying faulty electrical equipment with the potential to cause electric shock.

An Incident is an event that has occured. Example: team member used electrical equipment and suffered an electric shock resulting in injury.

Note: Incidents include a near miss when an event occured but resulted in no injury. Example: team member used electrical equipment, saw a bright spark and smoke, but was not injured.
TEG Division where the Hazard/Incident took place
Do you want to make this report confidential?
Confidential Report will only be sent to the People team.
Report will be sent to Division Leader and People Team.
Do you want to make this report confidential? *Report will only be sent to Cast Welfare Officer and TEG Senior Project Management
Type of event
Did the incident result in an injury?
Date of Hazard/Incident

DayMonthYear
Date
Time of Hazard/Incident

Hour Minutes

AM/PM Option
Name of person completing report

First NameLast Name
Position/Job Title
Who is your manager?
Email of person completing report
example@example.com
Phone Number of person completing report
Please enter a valid phone number.Format: 0000000000.
Is Hazard/Incident in relation to an Event (e.g., concert, show, etc) or Activation (e.g., AO, Shopping Centre, other experiences)
Name of Event or Activation
Hazard/Incident location

Address

CityState

Post Code
Description/Summary of Hazard/Incident
List all corrective actions that have been taken to control the Hazard/Incident
List any other recommended actions or suggestions you may have for eliminating or reducing the issue
Upload any photos or relevant files.

Cancelof
Is the injured person a

Other
Contracting Company Name
Name of injured person

First NameLast Name
Select organisation that injured person is a member of
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Description of Injury
Part of Body Injured (Please mark below with circle):
Type of treatment provided
Has the team member had any time off (or is likely to have any time off)?
How many days off (or estimated days off) has the team member had?
Status
Should be Empty: