HSWA Risk Register + Incident Register

HSWA RISK REGISTER AND INCIDENT REGISTER

Business (PCBU): ✓Business name (PCBU)

PART A — RISK REGISTER

This risk register is kept to meet the primary duty of a person conducting a business or undertaking (PCBU) under the Health and Safety at Work Act 2015 (HSWA) to eliminate, or if that is not reasonably practicable minimise, risks to health and safety so far as is reasonably practicable.

1. HAZARD 1.1. Hazard

2. WHO IS AT RISK 2.1. Who is at risk

3. CRITICAL RISK 3.1. Critical risk? 3.2. ⚠️ Reform to HSWA due to take effect 1 April 2027 (a date that has already been pushed back once and remains politically contested) would let a "small PCBU" — fewer than 20 employees — focus its formal risk management primarily on critical risks; keep this register compatible with both the current and the reformed regime.

4. RISK RATING 4.1. Risk rating (after current controls) (assessed by likelihood × severity, after current controls).

5. CONTROL MEASURES 5.1. Control measures (hierarchy of controls) 5.2. Controls should follow the hierarchy: eliminate the hazard; if that is not possible, minimise it through substitution, engineering controls, administrative controls, and personal protective equipment, in that order of preference.

6. RESPONSIBILITY AND REVIEW 6.1. Responsible person: Responsible person Next review date: Next review date 6.2. Workers consulted on: Worker consultation date. HSWA requires the PCBU to engage with workers on matters that affect their health and safety.

PART B — INCIDENT REGISTER

7. INCIDENT 7.1. Date/time: Incident date/time Person affected: Person affected 7.2. Description: Incident description

8. NOTIFIABLE EVENT ASSESSMENT 8.1. Notifiable event assessment 8.2. A notifiable event — death, notifiable injury or illness (e.g. hospitalisation, amputation, serious burns), or notifiable incident (e.g. a near miss with serious potential) — must be reported to WorkSafe New Zealand as soon as practicable, and the site of the event preserved until an inspector attends or directs otherwise.

9. WORKSAFE NOTIFICATION 9.1. WorkSafe notification (method / reference / date)

10. RECORD RETENTION 10.1. Incident records, including notifiable event notifications, must be retained for at least 5 years.

Completed by ______________ Date ______________

— — — ⚠️ This is a boilerplate template, not legal advice. New Zealand employment, privacy, consumer, food-safety, and work health & safety law combines the Employment Relations Act 2000, the Holidays Act 2003 (under active reform via the proposed Employment Leave Bill), the Privacy Act 2020, the Consumer Guarantees Act 1986, the Fair Trading Act 1986, the Food Act 2014, and the Health and Safety at Work Act 2015 — several of which are mid-reform as of mid-2026 and change on fixed dates that this template flags but does not resolve for you. Have it reviewed and adapted by a lawyer or Employment New Zealand before use, check current guidance and free official templates at employment.govt.nz (including the Employment Agreement Builder at eab.business.govt.nz), and confirm the minimum wage and any other statutory rate in force on the date of use (rates change every 1 April).