10/28/2019
Gmail - eWHS Management System
Giovanni Martins <itsolutions.gio@gmail.com>
eWHS Management System
Google Forms <forms-receipts-noreply@google.com>
To: itsolutions.gio@gmail.com
28 October 2019 at 12:45
Thanks for filling in eWHS Management System
Here's what we've received from you:
eWHS Management System
Incident Report Log for Occupational Illness or Injury
Email address *
itsolutions.gio@gmail.com
Incident Details
Incident Type *
Accident/Injury
Illness/Disease
https://mail.google.com/mail/u/0?ik=a6d71da89d&view=pt&search=all&permmsgid=msg-f%3A1648610971713108251&simpl=msg-f%3A16486109717… 1/3
10/28/2019
Gmail - eWHS Management System
Details of Illness/Disease
Fill in all sections of this form. If the section is not applicable, write NA or Nil.
Location of the Incident *
Awesome Landscape Depot
Date of Incident *
February
9
2019
Time of Incident *
11:45
Person/s Affected by Illness/Disease *
Megan Smith
Department *
Depot
Nature of Illness/Disease *
Heatstroke
Details of the Illness/Disease *
Massive headache and feeling nauseous
Responses and/or Treatment Administered (indicate which is applicable) *
First Aid
Medical Treatment
Assistance Sought: Ambulance
Assistance Sought: Police
Assistance Sought: Counsellor
https://mail.google.com/mail/u/0?ik=a6d71da89d&view=pt&search=all&permmsgid=msg-f%3A1648610971713108251&simpl=msg-f%3A16486109717… 2/3
10/28/2019
Gmail - eWHS Management System
Nil.
Other:
Incident Reported by: *
Specify who sent the report.
Philip Samson
Logged by (Candidate Name): *
Giovanni
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