RESOURCES: Forms

Health and Safety

Revision Date

Form 52E40 Incident Investigation Report (113 kb)

R11/04

Inspection Report (81 kb)

 

Monthly Health and Safety Meeting Record (95 kb)

 

Form 57M2 Material Safety Data Sheet - 9 Sections (43 kb)

R6/99

Form 57M6 Material Safety Data Sheet - 16 Sections (66 kb)

R6/99

Form 57E1 Request for reasons for Prevention Division decision or order (69 kb)

10/03

First Aid

First Aid Assessment Worksheet (101 kb)

Sample FA Assessment: Restaurant (121 kb)

05/04

Sample FA Assessment: Residential Construction (116 kb)

05/04

First Aid Assessment Flow Chart (101 kb)

11/04

Form 52B23 First aid record (43 kb)

01/06

Form 55M60 Occupational first aid patient assessment (46 kb)

R01/06

Claims

Form 7 Employer's report of injury or occupational disease

Form 6 Application for compensation & report of injury or occupational disease (149 kb)

R03/06

Form 6A Worker's report of injury or occupational disease to employer (81 kb)

R04/05

Form 7A - no longer in use First aid report

R10/05

Form 6/7 Independent operator's application for compensation and report of injury or occupational disease (86 kb)

R03/06

Form 9 Employer's statement of return to work (67 kb)

R03/06

Request for Disclosure (40 kb)

R03/03

Registration

Form 1800 Employer's Registration application (79 kb)

Form 1801/1800 Personal Optional Protection insurance application package ( mb)

R12/05

Request for Written Reasons (23 kb)  

Appeals and other Requests

Form 63M1 WorkSafeBC Review Division - Request for Review (91 kb)

R11/05

Form 63M2 WorkSafeBC Review Division - Notice to Participate (78 kb)

01/03

Form 63M4 WorkSafeBC authorization of representative (207 kb)

R08/04

WCAT Appeal Guide (115 kb)

11/04

The Workers' Compensation Appeal Tribunal (WCAT) is the final level of appeal in the workers’ compensation system of British Columbia. It is independent of WorkSafeBC. To file an appeal, please contact WCAT directly for the most current procedures and forms.