Some of our online applications may not be available on Saturday, April 4, from 7:30 a.m. to midnight, as we prepare our systems for the revised Workers Compensation Act (R.S.B.C. 2019) to take effect. On Sunday, April 5, you may see references to the revised Act, but please note it does not take effect until April 6, 2020. We apologize for any inconvenience.
Worker's Authorization for Release of Personal Information (form 69W1)
By completing this form, you authorize WorkSafeBC to access your personal information relevant to injury/disease and pertaining to examination, treatment, history, and employment.
Publication Date: Mar 2015
File type: PDF (88 KB) Asset type: FormForm: 69W1