City on a Hill Incident and Hazard Form

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A hazard is any object, situation, or behaviour that has the potential to cause injury, ill health, or damage to property.
An incident is an event that already has caused injury, ill health, or damage to property.
A near miss is an event that almost caused injury, ill health, or damage to property.

Reports of harm to children and misconduct by staff or volunteers should be made at coah.co/report.

Are you reporting an incident/near miss that has taken place or a hazard? *

An incident or near miss has occured.

There is a hazard that needs to be addressed.

Your name

Your email address

Your contact number

Ministry area *

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