Internal Review Form


  • Internal Review Form (PDF 121kb)
    Document Type: Form
    Keycode: FOR676/03/01.10
    Category: Laws and Regulations, 
    Publication Date: 08 February 2010
    Date First Published: 04 July 2008
    Summary: This form should be used to apply for an internal review of a WorkSafe inspector's decision, including a request for an extension of time.

About this form


The Occupational Health and Safety Act 2004 and the Dangerous Goods and Equipment (Public Safety) Acts (Amendment) Act 2005, provide for review of inspectors decisions or non decisions by an internal review process upon application by an eligible person. Complete this form if you are seeking a review of an inspector’s decision or non decision, or a stay of a decision.


Where to send the form


Internal Review Unit
WorkSafe Victoria
GPO Box 4306
Melbourne VIC 3001

Fax Number: (03) 8663 5451
Email: internalreviewunit@worksafe.vic.gov.au

For all enquiries please contact the Internal Review Unit on (03) 8663 5450.