Forms
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Form 29 - superceded by Form 17 - Review of decision
Form 29 is superceded by Form 17. Form 17 allows a business or indiviual to apply for an internal review of a decision under the Work Health and Safety Act 2011, Work Health and Safety Regulation 2011, Electrical Safety Act 2002 or Safety in Recreational Water Activities Act 2011.
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Group training record
A sample form to use in recording workers' training
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Example of a certified diver assessment form
Use this template to assess a certified scuba diver.
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Safety Information for divers and snorkellers
Includes a medical declaration for snorkelling
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Medical declaration for non-certified diving
For use by non-certified diver.
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Form 133/133A: Employer reporting - Injury that may be compensable (reportable injuries)
Form for employers to report injuries that may be compensable (reportable injuries)
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Appendix 1 – Example records for a count of persons form
Use this template to record head counts of persons.
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Form 71 - Request for Work Health and Safety Prosecutor (WHSP) to commence a prosecution
Request the Work Health and Safety Prosecutor to bring a prosecution under section 231 of the Work Health and Safety Act 2011 (including in relation to the Safety in Recreational Water Activities Act 2011) or section 186A of the Electrical Safety Act 2002.
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Appendix 6 – Example combined dive site lookout and supervision for
Example template for combined dive site, lookout and supervision risk assessments.
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Appendix 5 – Example risk assessment to determine lookouts and supervision form
Example template for combined dive site, lookout and supervision risk assessments.
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Appendix 4 – Example environmental dive site and in-water risk assessment form
Use this template to do environmental dive site and in-water risk assessments.
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Form 44 - Provisional Improvement Notice (PINs)
Provisional Improvement Notice (PIN) form used at the workplace by the Workplace Health and Safety Representative.