Search this website
| Options Options
Search Type
Request removal of a Health and Safety Representative
Document Actions

Request removal of a Health and Safety Representative

A business may want to remove an HSR if they believe that the HSR has not performed satisfactorily or exercised their functions or powers correctly. For example, if the HSR:

  • Performed an HSR function or power for an improper purpose eg directing a worker to cease work for a reason other than health or safety.
  • Used or disclosed personal information they acquired as an HSR without that person’s consent or outside their role as an HSR.

A business may request that WorkSafe assist with removing an HSR, but for the regulator to remove an HSR there must be evidence that the HSR has not performed or exercised their functions or powers satisfactorily.

Wherever possible, when a concern regarding an HSR arises, the business should attempt to resolve the issue directly with their HSR.

Where attempts have been made and have failed to resolve an issue with an HSR, the business can request WorkSafe to assist.

Note that there must be evidence that reasonable efforts have been made to resolve the issue with the parties involved before the issue is referred to WorkSafe.

When contacting WorkSafe about the removal of an HSR you will need to provide:

  1. Any relevant information to support the request;
  2. Details of the discussions had and the actions taken to try to resolve the issue; and
  3. Contact details for all involved parties and details of their involvement.


Once we receive the form, WorkSafe will review the information provided and contact you as soon as possible.

WorkSafe will take into account all relevant information provided by the PCBU and the HSR (or their representative), and any other relevant information necessary to form a view as to whether or not, on the balance of probabilities, the HSR has performed or exercised his or her functions or powers satisfactorily.


Submitting your Request for Removal of a Health and Safety Representative form 

  1. Click the button below to access the form.
  2. The form is in a PDF format. You will need Adobe Acrobat to open it
  3. Save the form to your computer
  4. Type directly into the form all of the information we require
  5. Re-save the form with your information included
  6. Email the completed form to your local WorkSafe office. The contact details for each local office are on the back of the form.


Download the Request Removal of a Health and Safety Representative’ form [PDF; 336 KB]

Last updated 8 April 2016


On Monday 4 April 2016, the New Health and Safety at Work Act 2015 (HSWA) came into effect.

HSWA repeals the Health and Safety in Employment Act 1992, with immediate effect.

All references to the 1992 Act on this website and within our guidance will be progressively removed.