Forms

Form 87R Declaration

The declaration is to be used when there is no doctor available to attend the worker.

Application for reinsurance set limit

Form 42 - For use by self-insurers

Form 275 Notice of claim for damages

A twelve page form, last updated 2018

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.

Form 23 - Removal of worker from 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.

Healthy worker funding program application form

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

Form 17 - Application for internal review of decision

Complete this form to apply for an internal review of 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.

Form 29 - superceded by Form 17 - Review of decision

Form 29 is superceded by Form 17.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.

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

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

Form 578 Application for a major hazard facility licence

Application for a major hazard facility licence

Queensland Workers Memorial Honour Roll application and eligibility criteria

Queensland Workers Memorial Honour Roll application and eligibility criteria.

Injured worker authorisation

A form whereby an injured worker authorises the communication of information between their medical provider and employer in relation to their worker's compensation claim.