This online form is for reporting diseases that have occurred in a work environment or as a result of a work activity.

Before you start

This form should only be used to report work-related diseases as defined in the RIDDOR regulations. 

Please see the Riddor booklet and guidance for advice on whether you are the appropriate person to report an incident and if this is the correct form.

If you still need assistance please ring us on 0800 0320 121.

You will need to submit details about

  • yourself
  • the disease (including a description of what led to it)
  • the affected person
  • the doctor who diagnosed the disease

Disease NI2508A online form

Additional information

There are other online RIDDOR forms available depending on what type of incident you are trying to report.