Forms > Health Care Providers

Audiogram & Medical History Form
The computer audiogram and medical history form, completed when conducting industrial hearing tests in noisy industry.
$21.00

Batch Information Package
PACKAGE OF 500 FORMS This form that must accompany all industrial hearing tests submitted to WorkSafeBC for a single employer.
$20.00

Batch Information Sheet
PRICE SHOWN IS FOR ONE INDIVIDUAL SHEETThis form that must accompany all industrial hearing tests submitted to WorkSafeBC for a single employer.
$0.04

Dentist's report
This form is available online from http://www.worksafebc.com/forms/default.asp
$0.00

HEARING LOSS AND EMPLOYMENT QUESTIONNAIRE
This form is available online from http://www.worksafebc.com/forms/default.asp.
$0.00

Physician's Report
Physician's Report (8/11)
$0.00

Record of Hearing Test
STACK OF 100 INDIVIDUAL PRE CUT CARDS
$0.00