Apply In-Person:

1. To report Pesticide or Chemical Incident in person, the person concerned has to visit the nearest Department of Health office in South Africa.
2. The contact link of the South African Department of Health is as follows: Link
3. Visit the office of Health Department and ask for a Pesticide / Chemical Incident Report Form from the respective department.
4. Also, ask if any attachments should be submitted with the report form. Now, complete the form as required and attest it with your signature.
5. Attach the required documents with the completed form and submit the application package to the concerned authority at the office.
6. Once you submit the required documents, your request will be processed by the Provincial Health Department and forwarded to the National Department of Health.
7. After all the necessary examination and verification of the submitted documents is over, the National Department of Health will take necessary proceedings for the matter concerned.

• Completed report form
• Label of the Pesticide/Chemical involved
• Any relevant medical report
• Identity proof copy of the applicant
• Residential proof
• Any supporting document (as instructed)

Department of Health South Africa Head Office
Physical Adsress:Dr AB Xuma Building, 1112 Voortrekker Rd,
Pretoria Townlands 351-JR,
PRETORIA, 0187
South Africa
Postal Adsress:Private Bag X828,
PRETORIA,
0001
South Africa
Tel: 012 395 8000
Email: minister@health.gov.za
Website link

• Any person, who wants to report any incident caused due to pesticide/chemical poisoning and/or exposure, can apply.
• The application can be made by victim themselves or any person related to the victim like mother, parent, caregiver, farmer, manager or any other.

• Please approach the authorities for fees details.
  

Explain the time until which the certificate/document is valid.
e.g. Birth Certificate Valid Forever

Please attach documents that can be used by people. e.g. links

Please attach sample completed documents that would help other people.

Please explain processing time taken in obtaining the document/certificate.

Videos explaining the procedure or to fill the applications.
Attach videos using the following tag <&video type='website'>video ID|width|height<&/video&> from external websites.
Please remove the '&' inside the tags during implementation.
Website = allocine, blip, dailymotion, facebook, gametrailers, googlevideo, html5, metacafe, myspace, revver,
sevenload, viddler, vimeo, youku, youtube
width = 560, height = 340, Video ID = Can be obtained from the URL of webpage where the video is displayed.
e.gIn the following url 'http://www.youtube.com/watch?v=Y0US7oR_t3M' Video ID is 'Y0US7oR_t3M'.

• The applicant should make sure that the concerned official has been provided with required information and complete description of the pesticide/involved.

• Also, all the required documents must have submitted appropriately in order to avoid rejections.

• Name, address and contact details of the applicant
• Active ingredient of the pesticide/chemical
• Trade name, Manufacturer name and other particulars
• Date, location and other information of the event
• Workplace poisoning details

• According to the Rotterdam convention, it is essential that any Pesticide or Chemical incident that occurred in the Republic of South Africa be notified to the National Department of Health and obtains a report in order that the incident is immediately looked upon and necessary actions are taken.
  

Necessary instructions or information can be found at the beginning of the application form.

Please explain what are other uses of obtaining this document/certificate.
e.g. Birth Certificate can be used as proof of identity.

• Link
  
• Link
  

More information which might help people.