Form 5 - Reference of prohibition notice for review

Information status

All documents issued prior to 1 July 2017 were issued by the former Department of Commerce. Documents listed here are the latest versions available. For more information on this document, please contact

This publication is for: 
Employee / workerEmployer

If you wish to submit a review of a prohibition notice to the WorkSafe Western Australia Commissioner you will need to complete a reference of prohibition notice for review form.

Form – application
Last updated 21 May 2014

Share this page:

Last modified: