Direct deposit authorization

Request to reactivate claim

Email Authorization

Request for Disclosure of Claim Information

Employer Payroll Report 2024

The submission deadline is February 28, 2025.

Application for AAP for interjurisdictional trucking and transport

Application for explosives magazine storage and use permit

Asbestos control pre-project safety meeting

Application for Coverage Outside

Notification of ownership of radiation equipment - Form A

Director Exemption Application Form

Optional Coverage Cancellation Form

Yukon Health Care Provider Application

Assistive device request

Chiropractor's first report and assessment

Chiropractor progress report

Chiropractor discharge report

Functional abilities form

Appendix 1 - Barriers to return to work

Psychological functional abilities form

Physiotherapy Extension and Discharge Report

Physiotherapy initial assessment report

Wage Loss - Annual Medical Report for Physical Injuries

Authorization of a representative

Request for disclosure

Request for Disclosure of Employer Assessment Decision/Administrative Penalty

Request for Disclosure of Claim Information

Workplace Health & Safety Decisions/Orders/Administrative Penalty

Request for Reconsideration

Withdrawal of Reconsideration Request