Complete this form for every incident, near-miss, injury, behavioural event, restrictive practice, or allegation involving a participant. Complete as soon as possible after the event - while details are fresh. Refer to Incident Management & Reporting Policy (POL-INC-001).
Describe what occurred factually and chronologically. Stick to what was observed - do not include opinions, assumptions, or speculation. Use the participant’s own words where relevant (in quotes).
To be completed by Manager / Director after initial review.
Reportable to NDIS Commission? If Yes, the Director must notify within the required timeframe via the NDIS Commission Portal (my.ndiscommission.gov.au) or 1800 035 544. Record the notification reference number below.
To be completed within 5 business days of the incident as part of internal review.
Form ID: FORM-INC-001 | Retained 7 years (or until participant reaches age 25 if minor) | © 2026 Safe Hands Disability | ABN 31 315 518 918