Psychosocial hazard reporting form collection statement
The Victorian WorkCover Authority (WorkSafe) is a body corporate established under the Accident Compensation Act 1985. Contact your nearest WorkSafe office.
Personal and health information collected in this report may be used to assess and determine compliance with the Occupational Health and Safety Act 2004 and associated laws, and any associated legal proceedings.
The information may also be used for the administration and enforcement of legislation administered by WorkSafe Victoria including the Occupational Health and Safety Act 2004, administration and evaluation of WorkSafe Victoria's programs generally, for law enforcement functions and legal proceedings.
A WorkSafe inspector may be assigned to attend the workplace identified and make enquiries regarding your allegation. The attending WorkSafe inspector may refer this matter to another agency (if appropriate).
WorkSafe Victoria may disclose personal and/or health information for public health and safety purposes. WorkSafe Victoria may disclose personal and/or health information to its contractors and agents; to a court or tribunal; to other regulatory agencies (including police, for the purposes of investigating or conducting an interview in connection with the application), to government agencies such as AUSTRAC, and to any person authorised by the individual to whom it relates, or by law, to obtain it.
Collection of your personal and/or health information may be required by the Occupational Health and Safety Act 2004 and associated regulations. Failure to provide some of this information may affect our ability to investigate your allegation.
If you do not provide any of this information, your application may not be accepted or processed.