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Register Your Asbestos Exposure

If you’re worried about having been exposed to asbestos at some point in your life, CLICK HERE to REGISTER YOUR ASBESTOS EXPOSURE  with us so we can keep them on file. If you have photos that prove your exposure (eg. camping in Wittenoom), please attach them. 

Alternatively, copy the following information into an email, and send to: exposureregistry@asbestosdiseases.org.au

Full name:

Date of Birth:

Current Address:

Mailing Address (if different from above):

Home Phone:

Mobile:

Email:

Type Possible Exposure: (eg. home renovation, workplace exposure, living/working in Wittenoom)

Timing/Length of Possible Exposure: (eg. how many weeks/years/months)

Location: (eg. Wittenoom, address of renovation or workplace)

Any family members who have been diagnosed with an asbestos-related disease? Please clarify relationship to you.

 

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