Use this form to report:

• Any incident involving a sensitive issue (discrimination, sexual harassment or abuse)
• Any incident that was a near miss, something that could have been much worse or may have future implications.
• Something needs to change.
• Any incident involving injury
• Any incident that involved illness
• Any incident that involved a vehicular accident

This form will guide you through questions that relate to your type of incident. Please continue to the end.

Forms are saved in a secure and encrypted system only accessible by council risk management personnel.