Applying for registration as a hygiene sampler

On 31 March 2022, the Work Health and Safety (WHS) laws replaced the health and safety elements of the Mines Safety and Inspection laws. For information visit

All health and safety notifications, forms and guidance for mining and petroleum has moved to the WorkSafe website

Hygiene sampler registration form - 1493 Kb

This form is required to be registered as a Hygiene sampler form

Who can apply for registration?

To be registered as a hygiene sampler, a person must provide proof of qualification as a surface ventilation technician or surface ventilation officer. If these course(s) have not been undertaken, a person may apply citing their relevant qualification or experience related to occupational hygiene to meet competency requirements.

Hygiene registration lasts for five years. Re-registration will only be approved if evidence of current competency in air-monitoring skills is provided.

Required information

The completed and signed form must be lodged with a copy of the certificate(s) for:

  • surface ventilation technician


  • surface ventilation officer

including the course date(s).

Without the complete information, a sampler will not be registered to submit results into the Health and Hygiene system.

If seeking registration without these qualifications, please complete the application form and provide a work history stating relevant experience (e.g. places, dates, activities, responsibilities). The form and supporting documentation should be emailed directly to the Hygiene Manager.

Lodging the application

Submit by email to


Health and hygiene sampling including atmospheric, noise and biological monitoring.

Phone: (08) 9358 8001 (select option 2 - you can make your selection at anytime)