Apply for the OHS Essentials Program

This field is for validation purposes and should be left unchanged.

ABN(Required)

WorkCover policy number (if known)

Preferred OHS Essentials Provider (if known)

Business name(Required)

Business address(Required)

Street Address Address Line 2 City Postal code

Number of full time employees(Required)

Enter a number between 1 and 200 only

Number of part time/casual employees(Required)

Enter a number between 0 and 200 only

Industry(Required)

Nature of business

Contact name(Required)

First Last

Contact email(Required)

Contact phone number(Required)

Main safety topics you would like the consultant to address (select all that are relevant)(Required)

Association membership (select all that are relevant)

Where do you get your health and safety information from?

How did you hear about the program?

Making workplace safety easier