Information and Forms For Agencies

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.

Forms

  • 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

  • GB LaunchPad Flyer – PDF
  • GB Injury Hotline Poster – PDF
  • GB Injury Hotline Supervisor Flyer – PDF

Bulletins

  • Alternative Employer Incentive Scheme – online
  • Guidelines for settling of journey claims – online
  • Workers compensation insurance requirements for employers – online

Publications

  • Employers guide to workers’ compensation – PDF / Word

Support Services

  • Interpreting and Translating Services – web / email / phone 1800 334 944
  • Indigenous Support Services – email / phone 1800 334 944

Useful Links