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Collection of personal and health information
We use personal and health information from this form to:
- monitor, assess and investigate workplace incidents
- administer and enforce legislation administered by WorkSafe
- administer and evaluate WorkSafe’s programs generally
- conduct legal proceedings.
We collect this information as required by the:
- Occupational Health and Safety Act 2004
- other legislation administered by WorkSafe.
If you do not send this form, you may receive a fine.
Use of personal information
WorkSafe may share your information with:
- its contractors and agents
- other regulatory agencies
- a court or tribunal
- any person or organisation authorised by the individual to which it relates, or by law, to obtain it.
Contact WorkSafe’s Privacy team if you:
- have questions about how your personal or health information will be handled
- would like access to your information.
You can do this by emailing [email protected] or reading WorkSafe’s Privacy Policy.
WorkSafe Victoria (WorkSafe) is a body corporate established under Victorian workers compensation legislation.
Your nearest WorkSafe office
WorkSafe Advisory
WorkSafe's advisory service is available between 7:30am and 6:30pm Monday to Friday. If you need more support, you can also contact WorkSafe using the Translating and Interpreting Service (TIS National) or the National Relay Service.