Forms

Form for Reporting a case of disease or death from occupational exposure to a biological agent

The above form can be used to report a case of disease or death from occupational exposure to a biological agent.

Note: This form should be used to report cases of COVID 19 or deaths resulting from COVID 19 in employees resulting from occupational exposure to the SAR-CoV-2 virus.

Form of Notification for First Time Use of a Group 2/3 or 4 Biological Agent

The above form is to be used by laboratories to notify the Authority of first time use of a Group 2, 3 or 4 biological agent.

(doc, 63KB)

BAR2 Form.docx (size 48.3 KB)

COMAH notifiable incidents should be reported by completing the Notifiable Incident Notification Form and sending it by email to comah@hsa.ie

Please note that this form is not to be used for general accident and dangerous occurrence reporting - see our online accident reporting below for information on reporting accidents and dangerous occurrences.

Whether you’re an employee, a safety representative or a member of the public, you can use this form to make a complaint in relation to a workplace occupational safety, health or welfare issue

Form GA1 - Report of Thorough Examination

(pdf, 120KB)

Form GA2 - Report of Weekly Examination

(pdf, 140KB)

Form GA3 - Inspection of Work Equipment for Working at Height Form

GA3 - Scaffold Specific Inspection Form

(pdf, 369KB)

(pdf, 576KB)