Completing WCB Forms
Option A: To complete by hand: Print off one copy, complete in pen, make a copy for your records, and mail or fax the original to the WCB.

Option B: To complete on screen: Complete the form on screen, print two copies - sign one to mail or fax to the WCB, and keep the account needed to access this service and to view your WCB business transactions.

Option C: Some WCB forms can be submitted electronically. Click here for information on the benefits of setting up an @WCB Online Services account needed to access this service and to view your WCB business transactions.

Report a Work Injury
Complete the first form in the list and mail or fax to the WCB.

Adobe Acrobat Reader 3.01 or higher is required to view PDF documents. Download the document viewer (Acrobat Reader) from Adobe's web site at no charge.

Form Name	Last Modified	PDF Size
Chiropractor's Initial Report (CHI) See also: CHI User Manual	2007-Dec-19	175KB
Chiropractor's Progress/Discharge Report (CHP) See also: CHP User Manual	2007-Dec-19	189KB
Practitioner's Return to Work Report (PRTW) See also: PRTW User Manual	2008-Aug-01	49KB
Chiropractor's Billing Form (CHRO)	2000-Apr-06	121KB
Direct Deposit Application	2005-Oct-12	103KB
Lower Extremity Functional Scale (LEFS)	2008-Apr-08	53KB
Neck Disability Index (NDI)	2008-Apr-14	54KB
Quick Dash and Work Module for upper extremities	2008-Apr-08	234KB
Roland Morris for backs	2008-Apr-08	16KB