Request to review a notice


This form is to be used to apply for a review of decisions under the Work Health and Safety Act 2020, Work Health and Safety (General) Regulations 2022, Work Health and Safety (Mining) Regulation 2022 and the Work Health and Safety (Petroleum and Geothermal Energy Operations) Regulations 2022 in relation to matters for the performance of a function at a general workplace, mine or petroleum site. 

If you are seeking a review by the WorkSafe Western Australia Commissioner of an improvement notice issued under the Occupational Safety and Health legislation you are required to submit your request using the reference of improvement notice for review form.

A signed and dated copy of the form must be sent to WorkSafe before the notice expires. The form should be emailed to, or mailed to WorkSafe Western Australia Commissioner, Locked Bag 100 East Perth 6892, or hand deliver it to Level 1, Mason Bird Building, 303 Sevenoaks St, Cannington WA 6107. 

For mine sites (SRS users), a review of an improvement notice or a prohibition notice should be requested using SRS.

Further information

Form – application
Last updated 22 Apr 2022

Share this page:

Last modified: