---
title: WorkCover Victoria Workplace Injury Notification Form Template | Paperform
description: Professional WorkCover Victoria injury notification form template for Australian businesses. Report workplace incidents with complete details, witness statements, and medical certificate uploads.
url: "https://paperform.co/templates/workcover-victoria-workplace-injury-notification-form"
type: static
generatedAt: "2026-03-31T00:50:14.658Z"
---

[← Back to free form templates](/templates/)    ![WorkCover Victoria Workplace Injury Notification Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/workcover-victoria-workplace-injury-notification-form.png)
    [Preview](https://_preview.paperform.co/ai-template/workcover-victoria-workplace-injury-notification-form) [Use this template for free](/create?ai-template=workcover-victoria-workplace-injury-notification-form)    [Legal & Compliance Forms](/templates/category/legal/)[Industry-Specific Forms](/templates/category/industry-specific/) [Healthcare](/templates/industry/healthcare/)[Business](/templates/industry/business/)[Hospitality](/templates/industry/hospitality/)[Manufacturing](/templates/industry/manufacturing/)[Construction](/templates/industry/construction/) [Office Manager](/templates/role/office-manager/)[HR Manager](/templates/role/hr-manager/)[Manager](/templates/role/manager/)[Operations Manager](/templates/role/operations-manager/)[Safety Officer](/templates/role/safety-officer/)     About this free form template
When a workplace injury occurs in Victoria, timely and accurate reporting to WorkCover Victoria is essential for compliance and to ensure injured workers receive the support they need. This WorkCover Victoria Workplace Injury Notification Form streamlines the entire reporting process, helping employers meet their legal obligations while capturing all the critical details in one place.

Designed specifically for Victorian businesses, this template collects comprehensive incident information including the nature of the injury, circumstances surrounding the event, witness accounts, and medical documentation. The form guides you through each required field—from employee and employer details to incident location, injury description, and immediate actions taken—ensuring nothing is overlooked.

With conditional logic built in, the form adapts based on injury severity and incident type, showing relevant follow-up questions automatically. Upload medical certificates, photos of the incident scene, and supporting documents directly within the form, keeping all evidence organised and accessible for WorkCover claims processing.

Paperform's secure platform ensures all sensitive employee and medical information is handled with care, while integrations with tools like Google Drive, Slack, and email notifications keep your HR and safety teams informed immediately. You can even connect submissions to your existing case management systems using Stepper workflows to automatically create incident records, assign follow-up tasks, and track claim progress without manual data entry.

Whether you're a construction company, manufacturing facility, healthcare provider, or office environment, this template helps you respond quickly to workplace incidents, demonstrate duty of care, and maintain compliance with Victorian workplace health and safety regulations. Clear, professional, and easy to complete by managers or supervisors on-site, this form takes the stress out of injury reporting when it matters most.
       Built for growing businesses, trusted by bigger ones.   Trusted by 500K+ business owners and creators, and hundreds of millions of respondents.     ![Capterra - 4.8 out of 5](/images/capterra-st.jpg)
 ![Trustpilot - 4.8 out of 5](/images/trustpilot-st.jpg)
 ![G2 - 4.8 out of 5](/images/g2-st.jpg)
  [Try Paperform free now](/register)
## More templates like this
  [![Arbeidstilsynet Workplace Incident Report Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/arbeidstilsynet-workplace-incident-report-form.png)

### Arbeidstilsynet Workplace Incident Report Form

A comprehensive Norwegian workplace incident report form for submitting mandatory notifications to Arbeidstilsynet (Norwegian Labour Inspection Authority) with injury classification, witness statements, and regulatory compliance.](/templates/arbeidstilsynet-workplace-incident-report-form/)
[![Argentina Workplace Injury Report Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/argentina-workplace-injury-report-form.png)

### Argentina Workplace Injury Report Form

Comprehensive workplace injury report form for Argentine employers to document incidents and coordinate with AFIP and ART insurance providers in compliance with labor regulations.](/templates/argentina-workplace-injury-report-form/)
[![Hong Kong Occupational Safety and Health Incident Report Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/hong-kong-occupational-safety-and-health-incident-report-form.png)

### Hong Kong Occupational Safety and Health Incident Report Form

A comprehensive incident report form compliant with Hong Kong's Occupational Safety and Health Ordinance (OSHO), designed to capture workplace accidents, injuries, and near misses with witness statements and Labour Department notification requirements.](/templates/hong-kong-occupational-safety-and-health-incident-report-form/)
[![WorkCover NT Injury Management Program Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/workcover-nt-injury-management-program-form.png)

### WorkCover NT Injury Management Program Form

A comprehensive injury management program form for Northern Territory employers to document workplace modifications, graduated return to work plans, and medical reviews in compliance with NT WorkCover requirements.](/templates/workcover-nt-injury-management-program-form/)
[![Dutch Labor Inspection Self-Assessment Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/dutch-labor-inspection-self-assessment-form.png)

### Dutch Labor Inspection Self-Assessment Form

A comprehensive self-assessment form for Dutch businesses to evaluate workplace safety, working conditions, and compliance with labor inspection standards.](/templates/dutch-labor-inspection-self-assessment-form/)
[![Korean COVID-19 Workplace Safety Checklist](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/korean-covid-19-workplace-safety-checklist.png)

### Korean COVID-19 Workplace Safety Checklist

A comprehensive workplace safety checklist for businesses in South Korea to ensure compliance with COVID-19 protocols, including quarantine procedures, contact tracing, and health monitoring requirements.](/templates/korean-covid-19-workplace-safety-checklist/)
[![Queensland Workplace Health and Safety Incident Report](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/queensland-workplace-health-and-safety-incident-report.png)

### Queensland Workplace Health and Safety Incident Report

A comprehensive WHS incident report form for Queensland workplaces to document incidents, identify hazards, record corrective actions, and obtain WHS officer sign-off in compliance with Work Health and Safety Act 2011.](/templates/queensland-workplace-health-and-safety-incident-report/)
[![Vendor & Contractor Misconduct Report Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/vendor-contractor-misconduct-report-form.png)

### Vendor & Contractor Misconduct Report Form

Report misconduct, code of conduct violations, or contract compliance issues involving external vendors and contractors who interact with your organization.](/templates/vendor-contractor-misconduct-report-form/)
[![ACC Workplace Injury Claim Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/acc-workplace-injury-claim-form.png)

### ACC Workplace Injury Claim Form

Report workplace injuries and file ACC claims with comprehensive incident details, witness statements, and medical documentation. Streamlined for New Zealand employers and employees.](/templates/acc-workplace-injury-claim-form/)
[![ACC Workplace Safety Management Programme Audit Self-Assessment](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/acc-workplace-safety-management-programme-audit-self-assessment.png)

### ACC Workplace Safety Management Programme Audit Self-Assessment

A comprehensive self-assessment form for evaluating your workplace safety management programme against ACC tertiary level criteria to determine eligibility for ACC levy discounts.](/templates/acc-workplace-safety-management-programme-audit-self-assessment/)
[![Australian Contractor ABN Declaration Form](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/australian-contractor-abn-declaration-form.png)

### Australian Contractor ABN Declaration Form

Collect ABN details, verify business structure and PAYG withholding exemption status from contractors working in Australia. Ensures ATO compliance for businesses engaging independent contractors.](/templates/australian-contractor-abn-declaration-form/)
[![Chilean Workplace Accident Report Form (Mutual de Seguridad)](https://img.paperform.co/fetch/f_webp/https://d3gw2uv1ch7vdq.cloudfront.net/content/form_templates/assets/chilean-workplace-accident-report-form-mutual-de-seguridad.png)

### Chilean Workplace Accident Report Form (Mutual de Seguridad)

Professional workplace accident report form for Chilean companies, compatible with ACHS, IST, and Mutual de Seguridad systems, ensuring immediate notification and regulatory compliance.](/templates/chilean-workplace-accident-report-form-mutual-de-seguridad/)