Equipment order form

Use this form to order, request repairs or extend the hire of equipment for injured workers.

Published: 30 Mar 2022
File type: DOC
File size: 123.11 kB
Length: 2 pages
Reading level: Medium

What it contains

This form can be used by WorkSafe agents, prescribing therapists and occasionally hospitals to order equipment. Details to be completed in the form include:

  • the equipment order details, including the equipment category, service and supplier details, and prescribing therapists and medical practitioner details
  • the injured employee's details
  • details about the equipment or repairs and maintenance needed

At the end of the document, there is also information about how WorkSafe collects personal information.