Forms

FM106 Claim Form

Use this form to make a claim with WorkCover Queensland or your self-insurer for a work-related illness or injury.

Be recognised - Assessment for silver recognition

Be recognised silver application form to be recognised for health and wellbeing at work.

Form 106 - Queensland health and safety representative (HSR) training provider application

Form 106 - Queensland health and safety representative (HSR) training provider application

Health and safety checklist for working from home

Checklist to assess WHS risks for working from home arrangements.

Form 39 - Completion statement by registered training organisation (RTO) and employer

Completion statement by registered training organisation (RTO) and employer

Service provider application form

Form 301: Completing this form does not guarantee referrals from WorkCover Queensland.

Online services injury and payment profile database - Terms and conditions

Terms and conditions for the OIR Online services injury and payment profile database.

Form 325B - Application for a lung disease examination

An application form for a lung disease confirmation examination under the Worker's Compensation and Rehabilitation Act 2003.

Queensland Workers Memorial Honour Roll application and eligibility criteria

Queensland Workers Memorial Honour Roll application and eligibility criteria.

Authorisation of administrator user

Authorisation of administrator user representative for a third party organisation

Healthy worker funding program application form

Application form for high-risk industries for work health funding program

Form 23 - New notification of lead risk work

Lead is a highly toxic cumulative poison for which manufacturers and importers must prepare, review, amend and provide Safety Data Sheets and suppliers must provide the Safety Data Sheets and label lead containers.