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