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Equipment order form

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


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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.