Workers Care forms and resources
This page is for services providers working with Workers Care. It provides access to forms and information sheets to help you when working with us.
Browse our forms and resources
Requesting services for an injured person
Working with people with challenging behaviour
Assessment tools
American Spinal Injury Association (ASIA) Impairment Scale
Care and Needs Scale (CANS)
- Care and Needs Scale form (CANS Adults)
- Care and Needs Scale electronic form (eCANS Adults)
- Care and Needs Scale (CANS) manual 2017
Depression, Anxiety, Stress Scales (DASS)
- Visit the UNSW website to download the DASS questionnaire.
FIM
Sydney Psychosocial Reintegration Scale 2 (SPRS 2)
- SPRS-2 manual
- SPRS-2 form A (self)
- SPRS-2 form B (self)
- SPRS-2 form A (clinician)
- SPRS-2 form B (clinician)
WHOQoL
Worker injury assessment
Attendant care
- Care Needs Assessor Expectations
- Attendant Care Service Request form
- Care Needs Assessment Report form
- Guide to completing a Care Needs Assessment Report (CNAR adults)
- Care Needs Review Report (CNRR)
- Guide to completing a Care Needs Review Report (CNRR adults)
- Care and Needs Scale (CANS)
Case managers
- Support and advocacy services - service providers
- Planning with an injured person
- Sample service provider profile for CM Finder
- Request to Amend Details
- Sargood on Collaroy – Information for case managers
Discharge planning
Equipment
- Consumables prescription form
- Consumables order form
- Consumables prescription variation form
- Consumables order variation form
- Completing consumables forms - information sheet
- Equipment Request form
- Equipment Evaluation Form
- Prosthetic request form
- Prosthetic repair/replacement request form
- Guidelines for prescribers - assistive technology
- Guidelines for prescribers - exercise and fitness equipment
Guidelines
Health Literacy Framework
Building Capability and Safeguarding Policy
Child Safety Guidance
Prosthetics guidance
- Guidance on the support pathway for people with a limb amputation (and trialling a prosthesis) 2021
- Summary for the support pathway for people with a limb amputation (2021)
- Limb prosthesis maintenance
- Tips on managing pain and limb amputation
Spinal cord guidance
- Guidance on the support needs of adults with spinal cord injury (SCI)
- Health Maintenance Toolkit - A guide for people with a spinal cord injury
- Support needs of adults with SCI - Information for the person and their family
- Support needs of adults with SCI - Assistive technology maintenance checklist
- Support needs of adults with SCI – Modified Caregiver Strain Index
Wheelchair guidelines
- Guidelines for the prescription of a seated wheelchair or mobility scooter
- Wheelchair guidelines – Consumer information
- Wheelchair guidelines - Summary
- Wheelchair guidelines – Supplement on wheelchair features - standing wheelchairs
- Wheelchair guidelines – Technical report
- Wheelchair guidelines – Goals checklist
- Wheelchair guidelines – Injury prevention during transport checklist
- Wheelchair guidelines – Long term needs checklist
- Wheelchair guidelines – Maintenance checklist
- Wheelchair guidelines – Shoulder injury prevention checklist
- Wheelchair guidelines – Training topics checklist
- Wheelchair guidelines – Wheelchair comfort tool
Home modifications
- Minor building modification assessment report & authority to install form
- Major building modification assessment report
- Building modification variation request
Invoicing and payment
For guidance regarding fee orders for service provision, please access the relevant information for your profession on the SIRA website.
- How to invoice Workers Care Program
- Invoicing requirements – Workers Care
- Payment codes – Workers Care
- Vendor business details form
Requesting services for an injured person
Go to Requesting services on behalf of an injured person for more information.
Additional forms and resources are available on the SIRA website.
General requests
Returning to work and study
For guidance about working in the NSW Workers Compensation Scheme please visit the SIRA website.
Visit the List of SIRA forms to access forms to request SIRA Vocational Rehabilitation Programs for workers.
Telehealth
Travel
- Cabcharge booking form
- Travel booking form (participant/worker)
- Travel booking form (service provider)
