Audit Registration Form

Company Audit Information

Company Name(Required)

First Name(Required)

Last Name(Required)

Street Address(Required)

Address Line 2

City(Required)

Province(Required)

Postal Code(Required)

Phone(Required)

Email(Required)

How long has the company's current Health & Safety Management System/Program been in place?(Required)

Audit Start Date(Required)

Audit Purpose

Certification

Maintenance

Renewal

Students

Qualification

Baseline

Regulatory Jurisdiction(Required)

Federal

Provincial

Regulatory Jurisdiction for PIC Member

Yes

HSSB Employee Information

Must be an employee of the company

Employee First Name(Required)

Employee Last Name(Required)

Training Date(Required)

Certification Number(Required)

WCB Information

If the company has more than one WCB Account Number fill out the Group Audit Application Form and submit along with this form

Account Number(s)(Required)

Industry Code(s)(Required)

Auditor Information

Choose(Required)

Internal

Consultant

Auditor First Name(Required)

Auditor Last Name(Required)

Auditor Certification Number(Required)

Date Taken(Required)

Team Audit

Complete this section if more than one auditor participated in the audit.

Team Audit (More than one auditor participated in the audit)(Required)

Auditor 2 First Name(Required)

Auditor 2 Last Name(Required)

Auditor Certification Number(Required)

Date Taken(Required)

Select(Required)

I (the Auditor 1) acknowledge that I have read and understood the Team Auditor process.

I (the Auditor 2) acknowledge that I have read and understood the Team Auditor process.

Audit Scope

Total Number of Employees(Required)

Total Number of Sites(Required)

Notes/Comments

To request a COR audit, please complete the form below. If you’re applying for a group audit, use the separate Group Audit Application Form, which includes Appendix H1 and H2, available via the button below. Prefer a printable version? You can also download the PDF form directly.