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CAQA Meridian Business Group · Simulated workplace

Incident and Hazard Report Form

FormControlled document
MER-FRM-020
v2.0
Document ownerQuality, Risk and Compliance Manager
Version2.0
Approved18 March 2026
Next review18 March 2027
StatusCurrent

Purpose. Used by any worker to report an injury, near miss, hazard, psychological health concern, privacy incident or property damage so it can be recorded, assessed and acted on.

1.When to use this form

Complete this form for any injury, near miss or hazard at either office, while working remotely or at a client site, for any concern about workload or behaviour that affects psychological health, and for any suspected privacy or information security incident. Complete it within one working day.

2.What happens next

The Quality, Risk and Compliance Manager records the report in the risk and compliance register and assesses it within one working day. Your manager will discuss the report with you and agree actions. Privacy incidents are assessed under the data breach section of the Privacy and Information Security Policy.

3.Describing the event

Describe what happened, where, when and what task you were doing. Stick to facts. Name any witnesses. For a psychological health concern, describe the situation and its effect on you without needing to name a cause if you prefer not to.

4.Confidentiality

Reports about psychological health or behaviour are handled confidentially by the People Services Manager and the Quality, Risk and Compliance Manager. Medical information is stored separately with restricted access.

5.Protection

Nobody will be treated adversely for reporting a hazard, incident or concern in good faith.

6.Complete the form

MER-FRM-020 v2.0 · CAQA Meridian Business GroupUncontrolled when printed. Simulated document created by CAQA for training and assessment.

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