Record of WHS consultation
(Work Health and Safety Act 2011)
Consulting with your workers, Health and Safety Representative/s (HSR), health and safety
committee and other persons conducting a business or undertaking (PCBUs) is not only good
management; it’s also required under the legislation and is a great way to improve and maintain
health and safety in your workplace.
This template can be used / modified to help keep a record of consultation with your workers and
other PCBUs.
Reason for consultation:
Date:
Specific issues:
Identify a hazard / assess risk/s Eliminate a hazard and associated risks
Facilities for workers Workplace WHS changes
WHS procedure/s Other
Who is consultation with?
Workers Other PCBUs
HSRs Other (specify)……………………………..
HSRs representative WHS Committee
Names and positions of those present:
Description of issue for consultation:
List any concerns raised during discussion:
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List decisions made (including date for completion, further action/s required, person/s
responsible):
Signature of attendees : Issue resolved/not resolved:
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