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Work Incident Report Form

Work Incident Report Form

Use a work incident report form pdf template to make your document workflow more streamlined.

Respect to the provision of hearing services and devices to workers. This form should be completed by the audiologist or audiometrist approved by WorkSafe to provide hearing services to injured workers with a work-related hearing loss and who has performed the assessment on the worker. The completed form must be sent to the WorkSafe Agent or self-insurer following assessment. All sections should be completed. Please provide reasons if you are unable to complete a section of the form as...
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