Food & Beverage
WorkSafeBC Form 55B23: First Aid Record
This official WorkSafeBC form is for documenting an injury that required first aid.
WorkSafeBC Form 52E40: Employer Incident Investigation Report
This official WorkSafeBC form is for documenting the details of incident investigations.
Form K: Employee Orientation Checklist for Return-to-Work Programs
This checklist describes what a supervisor needs to tell employees about the RTW program.
Form J: Modified Work List
This form describes how a modified work list should be developed and includes a sample list for food and beverage operations.
Form I: Return to Work Plan
This form is for documenting an RTW plan to get an injured employee back to regular duties.
Form H: Manager/Supervisor Communication Log
This form is for documenting communications with injured employees regarding return to work planning.
Form G: Time Loss and Medical Aid Checklist (Reportable Incidents)
This checklist describes steps to follow for incidents that require care from a health-care provider or time away from work.
Form F: No Time Loss and No Medical Aid Checklist (Non-Reportable Incidents)
This checklist describes steps to follow for incidents that don’t require care from a health-care provider or time away from work.
Form C: Physician Assessment – Return-to-Work Planning
Physicians can use this form to describe an injured employee’s physical capacity and work restrictions.
Form B2: Letter to Physician-Modified Work
This is a letter for the employer to send to an injured employee’s physician. It explains that there is an offer of work duty accommodations, which are described in the Modified Work Offer form.