Workplace Injury Commission (WIC) Application for Conciliation Form
The request for Conciliation Form and Checklist is available for download in pdf format." It can be completed on your computer prior to printing."
To request WorkCover Assist to help with your dispute, just tick the box on the Request for Conciliation Form where it asks:
Do you require an assistance provider at conciliation?
- Tick Yes
- Next to WorkCover Assist tick 'Yes'
What if I have already completed and sent the form to the WIC?
WIC will add WorkCover Assist to the dispute.
Reviewed 10 October 2022