{"id":8915,"date":"2026-07-29T06:57:11","date_gmt":"2026-07-29T06:57:11","guid":{"rendered":"https:\/\/limelightpeople.com.au\/?page_id=8915"},"modified":"2026-07-31T06:35:11","modified_gmt":"2026-07-31T06:35:11","slug":"submit-incident-report","status":"publish","type":"page","link":"https:\/\/limelightpeople.com.au\/candidates\/submit-incident-report\/","title":{"rendered":"Submit an Incident Report"},"content":{"rendered":"\n\n<!-- Basic Banner Start -->\n                          <h1>Use our secure incident report form to quickly and accurately document workplace injuries, safety hazards, or near misses. Submit details online now.<\/h1>\n          <img decoding=\"async\" src=\"https:\/\/cdn-01.cms-ap-v2i.applyflow.com\/limelightpeople\/wp-content\/uploads\/2026\/06\/Frame-1686555660-2-2.png\" fetchpriority=\"high\" alt=\"Use our secure incident report form to quickly and accurately document workplace injuries, safety hazards, or near misses. Submit details online now.\"\/>\n          <img decoding=\"async\" src=\"https:\/\/cdn-01.cms-ap-v2i.applyflow.com\/limelightpeople\/wp-content\/themes\/af-custom-child\/assets\/banner-backdrop.png\" alt=\"Backdrop Image\"\/>\n<!-- Basic Banner End -->\n<!-- Contact Form Start -->\n                      <h2>Submit details online now.<\/h2>\n<form enctype=\"multipart\/form-data\" method=\"post\" id=\"form_incident_report_form\" data-token=\"2797f37c0d0acfa4038aebabe4ac2d76\">\n<fieldset>\n<legend>Incident Report Form<\/legend>\n<h3>Incident Report Form<\/h3>\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"13\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_13\" id=\"frm_hide_fields_13\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"incident_report_form\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_13\" name=\"frm_submit_entry_13\" value=\"7ea3e6f95f\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/?page_id=8915&#038;fl_builder\" \/>\n<h3>Personal Information<\/h3>\n    <label for=\"field_ngtnx3\" id=\"field_ngtnx3_label\">First name\n        *\n    <\/label>\n    <input type=\"text\" id=\"field_ngtnx3\" name=\"item_meta[98]\" value=\"\"  placeholder=\"Enter your first name\" data-reqmsg=\"First name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\n    <label for=\"field_hmvg3\" id=\"field_hmvg3_label\">Last name\n        *\n    <\/label>\n    <input type=\"text\" id=\"field_hmvg3\" name=\"item_meta[99]\" value=\"\"  placeholder=\"Enter your last name\" data-reqmsg=\"Last name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\n    <label for=\"field_c529g3\" id=\"field_c529g3_label\">Email Address\n        *\n    <\/label>\n    <input type=\"email\" id=\"field_c529g3\" name=\"item_meta[100]\" value=\"\"  placeholder=\"Enter your email address\" data-reqmsg=\"Email Address cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\n    <label for=\"field_rxfao3\" id=\"field_rxfao3_label\">Contact Number\n        *\n    <\/label>\n    <input type=\"tel\" id=\"field_rxfao3\" name=\"item_meta[101]\" value=\"\"  placeholder=\"Enter your contact number\" data-reqmsg=\"Contact Number cannot be blank.\" aria-required=\"true\" data-invmsg=\"Phone is invalid\" aria-invalid=\"false\" pattern=\"((+d{1,3}(-|.| )?(?d)?(-| |.)?d{1,5})|((?d{2,6})?))(-|.| )?(d{3,4})(-|.| )?(d{4})(( x| ext)d{1,5}){0,1}$\"  \/>\n\t<label for=\"field_lumry\" id=\"field_lumry_label\">Position\n\t\t*\n\t<\/label>\n\t<input type=\"text\" id=\"field_lumry\" name=\"item_meta[108]\" value=\"\"  data-reqmsg=\"Position cannot be blank.\" aria-required=\"true\" data-invmsg=\"Position is invalid\" aria-invalid=\"false\"   \/>\n\t<label for=\"field_fqwx2\" id=\"field_fqwx2_label\">Organisation\n\t\t*\n\t<\/label>\n\t<input type=\"text\" id=\"field_fqwx2\" name=\"item_meta[109]\" value=\"\"  data-reqmsg=\"Organisation cannot be blank.\" aria-required=\"true\" data-invmsg=\"Organisation is invalid\" aria-invalid=\"false\"   \/>\n\t<label for=\"field_n9193\" id=\"field_n9193_label\">Please Nominate your Consultant\n\t\t*\n\t<\/label>\n\t\t\t<select name=\"item_meta[137]\" id=\"field_n9193\"  data-frmval=\"Beca Hartson\" data-reqmsg=\"Please Nominate your Consultant cannot be blank.\" aria-required=\"true\" data-invmsg=\"Please Nominate your Consultant is invalid\" aria-invalid=\"false\">\n\t\t<option  value=\"Beca Hartson\" selected='selected'>Beca Hartson<\/option><option  value=\"Carly Green\">Carly Green<\/option><option  value=\"Cassia Roberts\">Cassia Roberts<\/option><option  value=\"Daniel Waldron\">Daniel Waldron<\/option><option  value=\"Danielle Kirby\">Danielle Kirby<\/option><option  value=\"David Steven\">David Steven<\/option><option  value=\"Ian Gingell\">Ian Gingell<\/option><option  value=\"Jake Dennis\">Jake Dennis<\/option><option  value=\"Kate Heeligan\">Kate Heeligan<\/option><option  value=\"Laura McCarthy\">Laura McCarthy<\/option><option  value=\"Mackenzie Hannan\">Mackenzie Hannan<\/option><option  value=\"Owen Murphy\">Owen Murphy<\/option><option  value=\"Rachael Farrell\">Rachael Farrell<\/option>\t<\/select>\n\tThis is to notify us of a:\n\t\t*\n\t\t\t\t\t\t<label  for=\"field_1v7zz-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[110]\" id=\"field_1v7zz-0\" value=\"Death\"\n\t\t data-reqmsg=\"This is to notify us of a: cannot be blank.\" data-invmsg=\"This is to notify us of a: is invalid\"   \/> Death<\/label>\n\t\t\t\t\t<label  for=\"field_1v7zz-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[110]\" id=\"field_1v7zz-1\" value=\"Serious Ilness\"\n\t\t data-reqmsg=\"This is to notify us of a: cannot be blank.\" data-invmsg=\"This is to notify us of a: is invalid\"   \/> Serious Ilness<\/label>\n\t\t\t\t\t<label  for=\"field_1v7zz-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[110]\" id=\"field_1v7zz-2\" value=\"Serious Injury\"\n\t\t data-reqmsg=\"This is to notify us of a: cannot be blank.\" data-invmsg=\"This is to notify us of a: is invalid\"   \/> Serious Injury<\/label>\n\t\t\t\t\t<label  for=\"field_1v7zz-3\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[110]\" id=\"field_1v7zz-3\" value=\"Dangerous Incident\"\n\t\t data-reqmsg=\"This is to notify us of a: cannot be blank.\" data-invmsg=\"This is to notify us of a: is invalid\"   \/> Dangerous Incident<\/label>\n\t\t\t\t\t<label  for=\"field_1v7zz-4\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[110]\" id=\"field_1v7zz-4\" value=\"Other\"\n\t\t data-reqmsg=\"This is to notify us of a: cannot be blank.\" data-invmsg=\"This is to notify us of a: is invalid\"   \/> Other<\/label>\n\t<label for=\"field_svz0a\" id=\"field_svz0a_label\">Please provide an explanation of the type of incident\n\t\t*\n\t<\/label>\n\t<textarea name=\"item_meta[112]\" id=\"field_svz0a\" rows=\"5\"  data-reqmsg=\"Please provide an explanation of the type of incident cannot be blank.\" aria-required=\"true\" data-invmsg=\"Please provide an explanation of the type of incident is invalid\" aria-invalid=\"false\"><\/textarea>\n\t<label for=\"field_qa9a9\" id=\"field_qa9a9_label\">Date of the incident\n\t\t*\n\t<\/label>\n\t<input type=\"text\" id=\"field_qa9a9\" name=\"item_meta[113]\" value=\"\"  maxlength=\"10\" data-reqmsg=\"Date of the incident cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date of the incident is invalid\" aria-invalid=\"false\"  \/>\n\tTime of the incident\n\t\t*\n<select aria-label=\"Time of the incident ... hour\" name=\"item_meta[114][H]\" id=\"field_8yoyj_H\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-reqmsg=\"Time of the incident cannot be blank.\" aria-required=\"true\" data-invmsg=\"Time of the incident is invalid\" aria-invalid=\"false\"><option value=\"\"  selected='selected'><\/option><option value=\"12\">12<\/option><option value=\"1\">1<\/option><option value=\"2\">2<\/option><option value=\"3\">3<\/option><option value=\"4\">4<\/option><option value=\"5\">5<\/option><option value=\"6\">6<\/option><option value=\"7\">7<\/option><option value=\"8\">8<\/option><option value=\"9\">9<\/option><option value=\"10\">10<\/option><option value=\"11\">11<\/option><\/select>\n:\n<select aria-label=\"Time of the incident ... minute\" name=\"item_meta[114][m]\" id=\"field_8yoyj_m\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-reqmsg=\"Time of the incident cannot be blank.\" aria-required=\"true\" data-invmsg=\"Time of the incident is invalid\" aria-invalid=\"false\"><option value=\"\"  selected='selected'><\/option><option value=\"00\">00<\/option><option value=\"30\">30<\/option><\/select>\n<select aria-label=\"Time of the incident\" name=\"item_meta[114][A]\" id=\"field_8yoyj_A\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-reqmsg=\"Time of the incident cannot be blank.\" aria-required=\"true\" data-invmsg=\"Time of the incident is invalid\" aria-invalid=\"false\"><option value=\"AM\">AM<\/option><option value=\"PM\">PM<\/option><\/select>\n\t<label for=\"field_k7qcg\" id=\"field_k7qcg_label\">Describe the specific location of the incident\n\t\t*\n\t<\/label>\n\t<textarea name=\"item_meta[119]\" id=\"field_k7qcg\" rows=\"5\"  data-reqmsg=\"Describe the specific location of the incident cannot be blank.\" aria-required=\"true\" data-invmsg=\"Describe the specific location of the incident is invalid\" aria-invalid=\"false\"><\/textarea>\n<h3>Incident Details<\/h3>\n\t<label for=\"field_lpkk7\" id=\"field_lpkk7_label\">Outline in Detail the Incident \n\t\t*\n\t<\/label>\n\t<textarea name=\"item_meta[121]\" id=\"field_lpkk7\" rows=\"20\"  data-reqmsg=\"Outline in Detail the Incident  cannot be blank.\" aria-required=\"true\" data-invmsg=\"Outline in Detail the Incident  is invalid\" aria-invalid=\"false\"><\/textarea>\n\t<label for=\"field_olu2x\" id=\"field_olu2x_label\">Immediate Action Taken (if any)\n\t\t*\n\t<\/label>\n\t<textarea name=\"item_meta[123]\" id=\"field_olu2x\" rows=\"5\"  data-reqmsg=\"Immediate Action Taken (if any) cannot be blank.\" aria-required=\"true\" data-invmsg=\"Immediate Action Taken (if any) is invalid\" aria-invalid=\"false\"><\/textarea>\n\t<label for=\"field_zm0tm\" id=\"field_zm0tm_label\"> Has the incident been reported to management or anyone else within the business?\n\t\t*\n\t<\/label>\n\t<textarea name=\"item_meta[124]\" id=\"field_zm0tm\" rows=\"5\"  placeholder=\"If yes, please provide details of who has been notified and thier position within the organisation\" data-reqmsg=\" Has the incident been reported to management or anyone else within the business? cannot be blank.\" aria-required=\"true\" data-invmsg=\" Has the incident been reported to management or anyone else within the business? is invalid\" aria-invalid=\"false\"><\/textarea>\n\t<label for=\"field_xbros\" id=\"field_xbros_label\">Were there any witnesses?\n\t\t*\n\t<\/label>\n\t<textarea name=\"item_meta[125]\" id=\"field_xbros\" rows=\"5\"  placeholder=\"If yes, please provide details of name(s) and involvement in the incident.\" data-reqmsg=\"Were there any witnesses? cannot be blank.\" aria-required=\"true\" data-invmsg=\"Were there any witnesses? is invalid\" aria-invalid=\"false\"><\/textarea>\n\tI acknowledge that everything stated above is correct to my knowledge and is an accurate account of the events.\n\t\t*\n\t\t\t\t\t\t<label  for=\"field_e2qpt-0\">\n\t\t\t<input type=\"checkbox\" name=\"item_meta[126][]\" id=\"field_e2qpt-0\" value=\"Yes\"  data-reqmsg=\"I acknowledge that everything stated above is correct to my knowledge and is an accurate account of the events. cannot be blank.\" data-invmsg=\"I acknowledge that everything stated above is correct to my knowledge and is an accurate account of the events. is invalid\"   aria-required=\"true\"  \/> Yes<\/label>\n\t\t\t\t\t<label  for=\"field_e2qpt-1\">\n\t\t\t<input type=\"checkbox\" name=\"item_meta[126][]\" id=\"field_e2qpt-1\" value=\"No\"  data-reqmsg=\"I acknowledge that everything stated above is correct to my knowledge and is an accurate account of the events. cannot be blank.\" data-invmsg=\"I acknowledge that everything stated above is correct to my knowledge and is an accurate account of the events. is invalid\"   \/> No<\/label>\n\t<label for=\"field_zgx7r\" id=\"field_zgx7r_label\">Do you have any additional comments?\n\t\t*\n\t<\/label>\n\t<textarea name=\"item_meta[127]\" id=\"field_zgx7r\" rows=\"5\"  data-reqmsg=\"Do you have any additional comments? cannot be blank.\" aria-required=\"true\" data-invmsg=\"Do you have any additional comments? is invalid\" aria-invalid=\"false\"><\/textarea>\n    <label for=\"field_rzxx3\" id=\"field_rzxx3_label\">Please up load any images or client incident reports that have been compleated\n    <\/label>\n    <input type=\"hidden\"  data-invmsg=\"File Upload is invalid\" aria-invalid=\"false\"   name=\"item_meta[103]\"  value=\"\" data-frmfile=\"103\" \/>\n\t\t<input type=\"file\" name=\"file103\" id=\"field_rzxx3\"\n\t\t\t data-invmsg=\"File Upload is invalid\" aria-invalid=\"false\"  \t\t\t\/>\n\t\t\t\t\t\t<button type=\"button\" aria-label=\"Please up load any images or client incident reports that have been compleated. Drag and drop file here. Maximum file size: 5.24MB\">Drag and drop file here<\/button>\n\t\t<button type=\"button\" aria-label=\"Please up load any images or client incident reports that have been compleated. Upload file. Maximum file size: 5.24MB\">Upload file<\/button>\n\t\t\t<p>Maximum file size: 5.24MB<\/p>\n    <label for=\"g-recaptcha-response\" id=\"field_lfinu3_label\">Captcha\n    <\/label>\n<button type=\"submit\"   formnovalidate=\"formnovalidate\">Submit Incident Report<\/button>\n<a href=\"#\" tabindex=\"0\">Save Draft<\/a>\n<input type=\"hidden\" name=\"item_meta[136]\" id=\"field_ghc3v\" value=\"10\" data-frmval=\"10\"\/>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<label for=\"field_tla7g\">\n\t\t\t\tIf you are human, leave this field blank.\t\t\t<\/label>\n\t\t\t<input id=\"field_tla7g\" type=\"text\" name=\"item_meta[138]\" value=\"\"  \/>\n\t\t<input type=\"hidden\" name=\"frm_saving_draft\" value=\"\" \/><input name=\"frm_state\" type=\"hidden\" value=\"u0zv7TNApGbO1tweXHXPjmdXx0v9hUqQ62Xe657wZppdhzmC9hEK7yspEPkDwtPW\" \/>\n<\/fieldset>\n<\/form>\n<!-- Contact Form End -->\n","protected":false},"excerpt":{"rendered":"<p>Use our secure incident report form to quickly and accurately document workplace injuries, safety hazards, or near misses. Submit details online now. Submit details online now. Incident Report Form Incident Report Form Personal Information First name * Last name * Email Address * Contact Number * Position * Organisation * Please Nominate your Consultant *&hellip;<\/p>\n","protected":false},"author":10,"featured_media":0,"parent":414,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_seopress_titles_title":"Submit an Incident Report | Limelight People","_seopress_titles_desc":"Use our secure incident report form to quickly and accurately document workplace injuries, safety hazards, or near misses. 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