COVID-19 incident notification form

Notify WorkSafe about a positive confirmed diagnosis of COVID-19 in the workplace.
Last updated

Oct 2020

File type and size

PDF, 98.22 kB

What it contains

This form requests information about the impacted workplace and impacted person, in relation to a positive confirmed diagnosis of COVID-19. 

Important: Only complete this print form if you can't access, complete and submit the COVID-19 incident notification online form.

Access the online form

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