IntoWork Safety What is your name?*What would you like to report?*A hazardAn incidentHazard detailsWhat is the hazard?* Manual handling Ground conditions Machine interface Traffic management Environmental Housekeeping Slips, trips, falls Access/Egress Guarding Tool use Electrical PPE Vehicles Sharp edges Hazardous material Other Other hazard*Risk ranking*SevereHighMediumLowDescribe the hazardWhat action have you taken?Is further action required?*YesNoWhat action is required?Incident detailsWhen did the incident happen?What is the incident?* Near miss First aid Incident requiring first aid Major incident requiring hospitalisation Fatality Bullying and Harassment Environmental issue Vehicle issue Improvement notification Describe the incidentHave you submitted this to your on-site coordinator?*YesNoInjury detailsPart of body* Head Eyes Neck Trunk Back Arm Hand Leg Foot General Multiple Face Knee Other Other part of body*Injury* Fractures Dislocation Sprain/Strain Concussion Amputation Laceration Foreign body (eye) Superficial Contusion/Crush Burns/Scalds Multiple Welding flash Abrasion Other Other injury*Equipment used* Machinery/Cranes Power tools Other hand tools Lifting equip/Hoist Transport/Other Manual handling Equipment Environment Ladders Scaffolds Grinding Flying objects/Particles Floor/Work surface Other Other equipment used*Type of accident* Fall Slip/Trip/Stumble Struck by falling object Step down/Jumping Strike Against object Struck by object Caught in/Between Strain/Exertion Wind-blown object Temp/weather/heat/cold Elec/Friction Contact Chemical/Harmful substance Vehicle incident Other Other type of accident* This iframe contains the logic required to handle Ajax powered Gravity Forms.