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A hazard report form gives you a quick, factual way to record something unsafe, a near miss or an injury, and to remember who you told. This free form is written for workers on warehouse, factory and trades sites. It includes a plain-English summary of your rights, a table of what to do first, a report form and a follow-up log.
Your rights and duties
WorkSafe Victoria says labour hire workers have the right to a safe workplace, to refuse unsafe work, to be consulted on health and safety, and to be protected from discrimination for raising a concern. Both the labour hire provider and the host employer have duties to protect you. You also have duties: take reasonable care, follow safety instructions, and report hazards and incidents promptly to your host and your provider. Read the full WorkSafe Victoria labour hire workers page.
What the form includes
- Your rights at work: a short summary with a link to the WorkSafe Victoria page.
- What to do first: a table for emergencies, unsafe tasks, hazards, near misses and small injuries.
- Report form: your details, the site and area, the date and time, what happened, equipment involved, injuries, witnesses and what you did.
- Who I told: a log of the supervisor, safety representative and agency, with dates and replies.
- Follow-up: space to record whether the hazard was fixed.
How to use it
Keep a copy on your phone or in your bag. In an emergency, get to safety and call 000 first. For anything else, stop, tell your supervisor, and fill in the form while the details are fresh. Give the original to the person you report to and keep a copy. This form does not replace the site's own incident process.
Reporting through Chandler Personnel
Chandler's candidate FAQ says that if you are asked to do a task you believe is unsafe or beyond your training you should stop, discuss it with your supervisor, and call Chandler immediately if you are still unsure. It also says all incidents, accidents and near misses must be reported to Chandler, following the site protocols, and that an injured worker should seek site first aid and have someone notify the supervisor.
Related Resources
- WorkSafe Victoria: labour hire workers
- WorkSafe Victoria: labour hire induction and training
- First day on site checklist
- Licence and ticket tracker
- Chandler candidate FAQ
- Current jobs on the job board
Frequently Asked Questions
Can I refuse a task I think is unsafe?
WorkSafe Victoria says labour hire workers have the right to refuse unsafe work. Stop, explain your concern calmly to your supervisor, and contact your agency if you are still unsure.
What is a near miss?
An event where nobody was hurt but someone could have been, such as a pallet that nearly fell. Report it the same way as an incident.
Who should I tell first?
Your site supervisor, then your agency. In an emergency, get to safety and call 000.
Do I need to report a small injury?
Yes. Get site first aid, and have someone tell your supervisor. Small injuries can become bigger, and the record protects you.
Does this form work in states other than Victoria?
The rights summary follows Victorian WorkSafe guidance. If you work in another state, check that state's regulator, and follow the site's own reporting steps.
Stop, Tell, Write It Down
Download the form, keep it where you can find it, and use it the first time something looks wrong. When you are ready for your next placement, browse current jobs.
