Incident Report

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Incident Report

Health & Safety

Staying safe at DNA

Please fill out this form if any type of incident has happened at DNA.

When to use this form:

Please use this form if something has happened at
DNA that we need to know about.

Your Name *

Email *

Email

Confirm Email

Mobile *

Who does this report relate to? *

Staff
Contractor
Student
Visitor
Child
Other

Type of event *

Incident
Accident (Injury/Illness)
Security (including theft/trespass)
Technology
Property Damage
Other

What happened? *

Where did this happen? *

When did this incident happen? *

Date

Time

Who was involved and/or affected? *

Photos/Video of Incident

Click or drag files to this area to upload. You can upload up to 5 files.

Please upload any photos you have of what happened, what got broken, etc.

DNA’s mission is to create career pathways for whānau wanting to be part of digital tech industries. We do this to inspire them to become makers and innovators of technology, rather than users and consumers of it.

Contact Us

1251 Fenton Street, Rotorua Aotearoa New Zealand.

021 089 47828

[email protected]

www.digitalnatives.academy

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