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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.
PDF 130.5 kB 28 August 2020 -
FM106 Claim Form
Use this form to make a claim with WorkCover Queensland or your self-insurer for a work-related illness or injury.
DOCX 98.48 kB 28 August 2020 -
Be recognised - Assessment for silver recognition
Be recognised silver application form to be recognised for health and wellbeing at work.
PDF 231.82 kB 28 August 2020 -
Health and safety checklist for working from home
Checklist to assess WHS risks for working from home arrangements.
PDF 222.78 kB 6 April 2022 -
Form 39 - Completion statement by registered training organisation (RTO) and employer
Completion statement by registered training organisation (RTO) and employer
PDF 55.43 kB 28 August 2020 -
Service provider application form
Form 301: Completing this form does not guarantee referrals from WorkCover Queensland.
DOC 105.98 kB 28 August 2020 -
Form 106 - Queensland health and safety representative (HSR) training provider application
Form 106 - Queensland health and safety representative (HSR) training provider application
PDF 174.97 kB 28 August 2020 -
Online services injury and payment profile database - Terms and conditions
Terms and conditions for the OIR Online services injury and payment profile database.
PDF 148.88 kB 28 August 2020 -
Form 28 - Hazardous chemicals health monitoring report
Under the Work Health and Safety Regulation 2011 where health monitoring is required for a hazardous chemical, the PCBU must send a copy of the health monitoring report to Workplace Health and Safety Queensland in certain circumstances.
PDF 180.08 kB 30 June 2023 -
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.
PDF 691.69 kB 28 August 2020 -
Authorisation of administrator user
Authorisation of administrator user representative for a third party organisation
PDF 117.41 kB 28 August 2020 -
Queensland Workers Memorial Honour Roll application and eligibility criteria
Queensland Workers Memorial Honour Roll application and eligibility criteria.
PDF 209.85 kB 11 September 2020