Forms library
Important Information: All claim and policy forms, (with the exception of the Online Initial Notification of Injury form) must be printed, signed and forwarded to HEM to ensure notification is 'duly made' in accordance with the requirements of workers compensation legislation.
Claims & injury management
- Initial notification of injury (lodge online)
- Initial notification of injury (PDF)
- Workers compensation claim - worker (PDF)
- Workers compensation claim - employer (PDF)
- Injury on the journey (PDF)
- Statement of winess to an injury (PDF)
- Referral for occupational rehabilitation services (PDF)
Policy & premiums
- Direct debit service agreement and request form (PDF)
- Insurance proposal - Pubs, bars and taverns (PDF)
- Request for a certificate of currency (PDF)
Other forms
- Comments & suggestions (lodge online)
- Comments & suggestions (MSWord)
- Complaint (lodge online)
- Complaint (MSWord)
- Enquiry (lodge online)
To view the Adobe Acrobat format, you will need to have Free Adobe Acrobat Reader installed.