• Template Injury Management System (Word – 52kb)
    This template will assist employers to devise an appropriate injury management system for their workplace.


  • Template Return to Work Program (Word – 108kb)
    This template will assist employers to devise an appropriate Return to Work Program collaboratively with the injured worker.


  • Workplace Rehabilitation Referral Form (Word – 99kb)
    This form can be used by workers, employers or treating medical practitioners to request a referral to a workplace rehabilitation provider.


  • Form 6: Declaration of worker not residing in Western Australia (Word – 26kb, Fillable PDF – 136kb)
    This form is used to declare an injured workers’ incapacity when the injured worker does not reside in Western Australia.