WorkCover Queensland Serious Workplace Incident Notification Form
About this free form template

WorkCover Queensland Serious Workplace Incident Notification Form

When a serious workplace incident occurs in Queensland, time is critical. Under the Work Health and Safety Act 2011, employers and duty holders have a legal obligation to immediately notify WorkCover Queensland of serious incidents including deaths, serious injuries, and dangerous occurrences. This WorkCover Queensland Serious Workplace Incident Notification Form ensures you meet your compliance requirements while capturing all the essential details inspectors need to respond appropriately.

What is a notifiable incident in Queensland?

WorkCover Queensland requires immediate notification when a serious workplace incident occurs. Notifiable incidents include:

  • Death of a person at the workplace or arising from work activities
  • Serious injury or illness requiring immediate treatment or hospitalisation
  • Dangerous incidents that expose workers or others to serious risk, even if no injury occurred
  • Incidents requiring emergency services such as ambulance, fire or police attendance

This form template helps you quickly document all required information, contact emergency services where needed, and ensure WorkCover inspectors have the details they need to investigate and prevent future incidents.

Why use Paperform for WorkCover incident reporting?

Safety managers, HR teams, site supervisors and business owners across Queensland need a fast, reliable way to report serious workplace incidents. Traditional paper-based notification systems create delays, missing information and compliance gaps that can result in significant penalties.

Paperform's WorkCover Queensland notification template gives you:

  • Instant mobile reporting from any device, anywhere on your worksite
  • Conditional logic that shows relevant questions based on incident type (injury, fatality, dangerous occurrence)
  • Emergency contact capture to document when and which emergency services attended
  • Photo and file uploads for incident scene documentation, witness statements and supporting evidence
  • Automatic submission routing to safety officers, management and WorkCover as required
  • Secure data storage with audit trails for compliance and investigation purposes

Who needs this form?

This WorkCover Queensland incident notification form is essential for:

  • Construction companies and builders managing high-risk worksites
  • Manufacturing and industrial facilities with heavy machinery and equipment
  • Mining and resources operations across Queensland
  • Logistics and warehousing businesses with material handling risks
  • Healthcare facilities reporting patient handling injuries or infectious exposures
  • Hospitality and retail businesses with public liability incidents
  • Facilities managers responsible for workplace safety compliance
  • Safety officers and WHS coordinators managing incident response protocols

Key features of this template

This comprehensive notification form captures all information required by WorkCover Queensland inspectors:

Incident classification and timing

  • Type of incident (fatality, serious injury, dangerous occurrence)
  • Date, time and exact location of the incident
  • Whether emergency services attended and their contact details

Injured person or fatality details

  • Full name, contact information and employment details
  • Nature and severity of injuries sustained
  • Medical treatment provided and hospital details

Incident circumstances

  • Detailed description of what happened
  • Equipment, substances or activities involved
  • Contributing factors and immediate causes

Duty holder and business information

  • PCBU (Person Conducting a Business or Undertaking) details
  • ABN and business contact information
  • Person completing the notification

Inspector requirements

  • Incident scene preservation status
  • Witness availability and contact details
  • Supporting documentation ready for inspection

Streamline your incident response with automation

Beyond just capturing the notification, Paperform integrates with Stepper, our AI-native workflow automation platform, to turn each serious incident into a coordinated response:

  • Automatically notify safety managers, senior leadership and your insurance provider the moment an incident is reported
  • Create investigation tasks in your project management system with all incident details attached
  • Update your WHS register in spreadsheets or databases without manual data entry
  • Generate incident reports formatted for WorkCover submission and internal records
  • Track response timelines to ensure statutory notification deadlines are met

For businesses managing contracts and safety agreements, Papersign can streamline witness statements, contractor safety acknowledgments and incident investigation sign-offs with secure eSignatures linked directly to your notification records.

Compliance you can trust

Workplace safety compliance isn't optional in Queensland. Late or incomplete notifications can result in significant penalties, prosecution and increased scrutiny from WorkCover inspectors. This form template is designed with Queensland's specific regulatory requirements in mind, helping you:

  • Meet immediate notification obligations within required timeframes
  • Provide complete information that inspectors need for their investigation
  • Maintain comprehensive records for audits, insurance claims and legal proceedings
  • Demonstrate due diligence in your incident response procedures

Paperform is SOC 2 Type II compliant with secure data handling, role-based permissions and audit trails that give you confidence your sensitive incident data is protected while remaining accessible to authorised personnel.

Get started in minutes

You don't need technical expertise to deploy this WorkCover notification form. Simply customise the template with your business details, set up your notification workflows, and share the form link with supervisors and safety officers across your organisation. Because Paperform works on any device, your team can report incidents immediately from the worksite without returning to the office.

Whether you're a safety officer coordinating compliance across multiple sites, an operations manager responsible for incident response, or a business owner ensuring your WHS obligations are met, this template gives you the professional, compliant foundation you need for serious workplace incident notification in Queensland.

Trusted by Australian businesses

Paperform is trusted by over 500,000 teams worldwide, including thousands of Australian businesses managing workplace safety compliance. With local data residency options, responsive support, and templates built for Australian regulatory requirements, Paperform understands the specific needs of Queensland employers and duty holders.

Start with this WorkCover Queensland notification template and build out your complete safety management system—from near-miss reporting and hazard identification to training records and contractor inductions—all on one flexible, user-friendly platform.

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suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
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