Aurora Tower – Burswood
Hazard Report Form
Use this form to Report an OSH, Env, Public Liability, Property or Asset threat Hazard
Hazard Categories:
Physical: housekeeping, electrical, mechanical, pavers lifted, etc
Hazardous substances: toxicity, storage , handling etc
Environmental: Temperature, noise, dust, heat, radiation smoke, fumes etc
Ergonomic: manual handling, awkward postures, lifting etc
Psychological: stress, deadlines, workload etc
Biological: stings, bites, pathogens, needles / syringes, diseases etc

* required field
* Hazard Category
* Your Name
* Department / Team
* Date / Time
* Describe the Hazard
* What is the risk that the
identified hazard will cause
harm or injury or damage?
(refer to risk assessment matrix)
* List the actions taken by
the person reporting the
hazard to fix the hazard
Attach any relevant
documents, photos etc
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