Internal review application form - request to review a return to work inspector decision

Use this form to request a review of a Return to Work Inspector decision or non-decision.
Last updated

Mar 2019

Reading level


File Type and Size

PDF, 144.59 kB

Document Length

4 pages

What it contains

Blank form with information about the types of requests that can be made using the form.

Important: Please download this PDF to your computer. You can fill it in using Adobe Reader but it will not save if you attempt to fill it in using your web browser.