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.
Your full name
Your Email address
Retype Email address
Position
Mine ID

Option 2: Retrieve Existing Incident Report
Report No
Password

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