Information and Forms For Agencies
Visit the WorkSafe employer page for the latest forms and information and FAQs.
Please use the below forms for Northern Territory claims only.
- Workers’ compensation claim form – PDF / Word
- Statement of Fitness for Work Submission – online
- Medical & Pharmaceutical Items Reimbursement Form – online
- Workers Compensation Timesheet – Claim for Payment – online
- Travel Reimbursement Form – online / hardcopy
- Bank Account Details – for EFT Payments – online
- Miscellaneous/all other items Reimbursement Form – online
About GB’s services
- Alternative Employer Incentive Scheme – online
- Guidelines for settling of journey claims – online
- Workers compensation insurance requirements for employers – online
- Interpreting and Translating Services – web / email / phone 1800 334 944
- Indigenous Support Services – email / phone 1800 334 944