From 1 December 2011, new dispute resolution arrangements will be in place in the WA workers' compensation jurisdiction.

From that date all forms currently used within the Dispute Resolution Directorate will no longer be accepted. To support the new Conciliation and Arbitration Services, a suite of new forms will be used - see below.

It is likely that the forms may undergo some refinements in the early days of the new Services. Please feel free to provide your feedback on the forms to Peter Minchin, Conciliation and Arbitration Services Operations Manager at peter.minchin@workcover.wa.gov.au.

Conciliation Service Forms

• Form 100 - Application for Conciliation (PDF - 130kb)
• Form 100 - Application for Conciliation (Word - 330kb)

• Form 101 - Statement of Social and Financial Circumstances (PDF - 130kb)
• Form 101 - Statement of Social and Financial Circumstances (Word - 240kb)

• Form 103 - Request for an Order for Insurer to Make Payment of a Payment Direction (PDF - 70kb)
• Form 103 - Request for an Order for Insurer to Make Payment of a Payment Direction (Word - 210kb)

• Form 104 - Notice of Representation (PDF - 80kb)
• Form 104 - Notice of Representation (Word - 230kb)

• Form 105 - Multiple Respondent Notification (PDF - 70kb)
• Form 105 - Multiple Respondent Notification (Word - 230kb)

• Form 106 - Notice of Discontinuance (PDF - 70kb)
• Form 106 - Notice of Discontinuance (Word - 210kb)

• Form 107 - Memorandum of Consent to Finalising Order (PDF - 70kb)
• Form 107 - Memorandum of Consent to Finalising Order (Word - 210kb)

• Form 108 - Application for Order or Assessment of Costs (PDF - 70kb)
• Form 108 - Application for Order or Assessment of Costs (Word - 210kb)

Arbitration Service Forms

• Form 150 - Application for Arbitration (PDF - 180kb)
• Form 150 - Application for Arbitration (Word - 360kb)

• Form 151 - Application for Arbitration - Dispute Not Suitable for Conciliation (PDF - 180kb)
• Form 151 - Application for Arbitration - Dispute Not Suitable for Conciliation (Word - 360kb)

• Form 152 - Request to Extend Time to Make an Arbitration (PDF - 80kb)
• Form 152 - Request to Extend Time to Make an Arbitration (Word - 220kb)

• Form 153 - Statement of Social and Financial Circumstances (PDF - 130kb)
• Form 153 - Statement of Social and Financial Circumstances (Word - 240kb)

• Form 154 - Reply to Application for Arbitration (PDF - 110kb)
• Form 154 - Reply to Application for Arbitration (Word - 260kb)

• Form 155 - Certificate of Service (PDF - 80kb)
• Form 155 - Certificate of Service (Word - 220kb)

• Form 156 - Interlocutory Application (PDF - 90kb)
• Form 156 - Interlocutory Application (Word - 220kb)

• Form 157 - Memorandum of Consent Order (PDF - 70kb)
• Form 157 - Memorandum of Consent Order (Word - 210kb)

• Form 158 - Request for an Order for Production of Documents or Material (PDF - 70kb)
• Form 158 - Request for an Order for Production of Documents or Material (Word - 210kb)

• Form 159 - Summons to Witness (PDF - 100kb)
• Form 159 - Summons to Witness (Word - 220kb)

• Form 161 - Multiple Respondent Notification (PDF - 80kb)
• Form 161 - Multiple Respondent Notification (Word - 230kb)

• Form 162 - Notice of Representation (PDF - 80kb)
• Form 162 - Notice of Representation (Word - 230kb)

• Form 163 - Notice of Discontinuance (PDF - 70kb)
• Form 163 - Notice of Discontinuance (Word - 220kb)

• Form 164 - Application for Order or Assessment of Costs (PDF - 70kb)
• Form 164 - Application for Order or Assessment of Costs (Word - 210kb)