RISK/INCIDENT FORM
No injury sustained by customer. Used to report any faults, issues or potential risks related to customers, staff or the gym environment.
Gym Location
Adamstown
West Gosford
Warners Bay
Rutherford
Details of Reporter:
Name
First Name
Last Name
Gender
Female
Male
Prefer not to specify
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Number
Email
Details of Risk/Incident
Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
What is the risk?
Where exactly is the risk located?
What should be done to permanently eliminate/minimise risk?
Submit
Should be Empty: