Current Step 1 Step 2 Step 3 Step 4 Complete Please register your potential asbestos exposure with the Asbestos and Silica Safety and Eradication Agency’s database. Are you registering a potential asbestos exposure on behalf of yourself or someone else? Myself Someone else Your details Your full name Your email address Your phone number Include any international or local area code, no spaces I have the permission of the person for whom I am registering Please provide below the information about the person exposed to asbestos Personal Details Title Title - Select -MrMrsMsMissMasterDrProfRevOther… Enter other… Gender Male Female Not specified First name Surname Date of birth Please enter the date in dd/mm/yyyy format. For example 20/07/1969. Street address Suburb State/Territory State/Territory - Select -ACTNSWNTQLDSATASVICWAOverseas/other... Enter other... Postcode Email address Phone number Include any international or local area code, no spaces Next
