QUARTERLY SUMMARY HEALTH AND SAFETY REPORT
This form must be used in accordance with the
OHS Procedure – Health and Safety Management
School/Directorate Name: _________________________________________________________________________
Quarter: 1 / 2 / 3 / 4 (circle as appropriate) Year:
HIRAC Reviews Conducted during Quarter
ACTIVITY, TASK, PROJECT, ITEM OF PLANT, LOCATION
MONTH MAIN RISK CONTROL OUTCOMES
Meetings of the Health and Safety Improvement Team(s) Held during Quarter
Meetings held on the following dates:
1. 2. 3.
Other Relevant Health and Safety Issues (e.g. projects, incident, WorkSafe inspection, etc)
Specify here: ___________________________________________________________________________________________________________
Send report to relevant DVC/VP and copy to Manager – Risk, Health and Safety. Attach copies of First Aid Reports from any kit located
within your School/Directorate.
Page 1 of 1 Version: 21/07/2009