- Form 18: Notice of Arrangement of Audiometric Test (Word – 308kb)
This form is used to notify a worker that an audiometric test has been arranged including the appointment details and pre-appointment requirements of the worker.
- Form 410: Request for Baseline Full Audiological Assessment (Word – 50kb)
Form used by employers to request a full audiological assessment of a worker.
- Form 21: Notice of Dispute (noise induced hearing loss) (Word – 120kb)
This form can be used by workers or employers when disputing the results of an audiometric (hearing) test.
- Form 406: Authorisation to Release WorkCover WA Audiometric Test Results (Word – 98kb)
Form used by workers to authorise the release of their audiometric test results to whoever they specify.
- Form 412: Worker’s Consent to Release Hearing Test Results (PDF – 195kb)
This form can be used by a worker to authorise WorkCover WA to release their hearing test(s) results to a nominee.