Request for Disclosure of Claim Information

Email Authorization

Plainte en cas de représailles

Reprisal Complaint

Application for explosives magazine storage and use permit

Application for blasting permit

Direct deposit authorization

Immediate incident reporting for the worker

Request to reactivate claim

Optional Coverage Cancellation Form

Application for Registration

Application for Coverage Outside

Employer Payroll Report 2024

The submission deadline is February 28, 2025.

CHOICES Enrollment

Application for AAP for interjurisdictional trucking and transport

Application for explosives magazine storage and use permit

Application for mine rescue certification

Application for variance of a WHS regulation

Application to operate a diesel engine underground

Asbestos control pre-project safety meeting

Director Exemption Application Form

Notification of ownership of radiation equipment - Form A

Physiotherapy initial assessment report

Physiotherapy Extension and Discharge Report

Yukon Health Care Provider Application

Appendix 1 - Barriers to return to work

Assistive device request

Chiropractor's first report and assessment

Chiropractor progress report

Chiropractor discharge report

Dentist's first report

Doctor's first report

Doctor's progress report

Functional abilities form

Massage Therapy Report

Psychological functional abilities form

Psychological initial assessment report

Psychological progress report

Wage Loss - Annual Medical Report for Physical Injuries

Workplace Health & Safety Decisions/Orders/Administrative Penalty

Request for Disclosure of Claim Information

Request for Disclosure of Employer Assessment Decision/Administrative Penalty

Request for disclosure

Authorization of a representative

Request for Reconsideration

Withdrawal of Reconsideration Request

Demande d’indemnisation – Perte auditive

Application for Compensation Benefits - Hearing Loss

Prior approval request (Hearing claims)

Schedule A - Fee Structure (Hearing claims)

Service provider report (hearing claims)