Notification of Dangerous Incident

This form is for a person conducting a business or undertaking (PCBU) notifying the regulator of dangerous incidents involving serious risk, under section 38 of the WA Work Health and Safety Act 2020.

Please do not use this form to notify injuries/illnesses or report a hazard or breach (i.e. complaint) – click on the relevant link for these services.

Please do not use this form for mine sites, offshore oil or gas workplaces, workplaces outside of Western Australia and Commonwealth workplaces (e.g. Department of Defence), unless the notification involves contractors working on Commonwealth workplaces in WA.

Your contact details

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First name
Last name
Position
	Enter phone number or mobile number is mandatory
Phone number
Mobile number
Email address