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Required WorkSafe Forms

A library of appropriate documents for you to request services for your claim

WorkSafe Home Help Request Form

In order to request Home Help services (lawn mowing, gardening and cleaning) your treater will need to fill this out and submit to your managing insurer for review.

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WorkSafe Home Help Workers Declaration Form

In order to request Home Help Services initially, you must fill out this form and submit to your insurer accompanied with the "Worker Declaration Form" for review.

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3 Month Gym Swim Membership Request

In order to request a 3 month gym swim membership, this form must be filled out by your treater and submitted to your managing agent for review.

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