Form 5A - Queensland Mining Industry Incident Report Form

Choose one of the options below

Option 1: Log New Incident Report

If you just want to create a new Incident Report, start here.


(if applicable)
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Option 2: Retrieve Existing Incident Report
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Notes:

  • All fields are compulsory, unless otherwise stated.
  • If the mine code you enter does not match a valid code in our records, you will not be able to submit this form
  • This form does not replace the need for the site senior executive to notify an inspector of a serious accident or high potential incident.
  • Mining industry incident report manual - online forms (PDF, 222 kB) - instructions/definitions for completion of this on-line incident report form