Report Incident - CareWatch

Report New Incident

Incident(s)

Incident #1 (required)

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Incident Title *

Brief (5–200 characters)

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Incident Type

Severity *

Incident Date & Time *

Incident #2 (optional)

If you fill one field, complete all

Incident Title

Brief (5–200 characters)

0/200

Incident Type

Severity

Incident Date & Time

Your Role

Employer *

Worksite *

Detailed Description *

Minimum 20 characters. Be specific and objective.

0/2000 characters

Contact Information

Full Name

Only letters, spaces, apostrophes (’), and hyphens (-).

Contact Phone (Optional)

Enter NZ phone number without country code (+64)

Email *

We'll use this email to follow up if needed

Has this incident been reported to the Care Home or Health and Disability Commission? *

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By submitting this form, I confirm that:

The information provided is true and accurate
I authorize the processing of my data for the incident investigation

Completing this form does not replace filling in your own employer’s health and safety incident reporting forms, you should do that as well.

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Report New Incident

Incident(s)

Incident #1 (required)

Incident #2 (optional)

Incident #3 (optional)

Incident #4 (optional)

Incident #5 (optional)

Contact Information

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