Reporters Name
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First Name
Last Name
Reporters Email
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example@example.com
Reporters phone contact details
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Participants name
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Location Address
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State of Australia where home safety check was completed
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NSW
QLD
WA
VIC
SA
CAN
NT
TAS
Nationally or Multiple states
Please outline any special notes or circumstances to do with the property or various people within the property. Please note any hazards within the home or to do with access and note how the potential risks could be managed. If no risks identified please specify.
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Please upload any photos or related additional details to the risk if available here. (eg support notes report)
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Date reported
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