Report a Notifiable Event

 
Use this form to notify OutdoorsMark of a notifiable event as required by the OutdoorsMark terms and conditions. As defined in the act, a notifiable event means any of the following events that arise from work: (a) the death of a person; or (b) a notifiable injury or illness; or (c) a notifiable incident
What would you like to notify us about
PCBU details
Address
Address
Contact Person Name
Contact Person Name
PCBU phone no. (mobile)
PCBU phone no. (mobile)
PCBU phone no. (land line)
PCBU phone no. (land line)
Is the PCBU Investigating?
Reporter details
Is there a Health and Safety Rep (HSR) at the workplace?
I declare that to the best of my knowledge, the information provided in this notification is true and correct.
Name
Name
Address
Address
Phone
Phone
Date
Date