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Documents Listing
Filling out downloadable forms using a web browser may produce text formatting issues. Should those issues occur, please download the form first and then open it using the free Adobe Acrobat Reader DC software.
Accreditation Request – Mental Health Primary Level Services
Type:
Downloadable forms
Downloadable forms
Last updated:
March 9, 2022
March 9, 2022
User:
Care providers
Care providers
Use this form to request accreditation from the WCB to provide mental health primary level services to injured workers.
application/pdf — 147.32 KB
Accreditation Request – Primary Level Services
Type:
Downloadable forms
Downloadable forms
Last updated:
March 10, 2022
March 10, 2022
User:
Care providers
Care providers
Use this form to request accreditation for a care provider joining your assessment team.
application/pdf — 148.12 KB
Accreditation Request – To add assessment team member
Type:
Downloadable forms
Downloadable forms
Last updated:
November 16, 2021
November 16, 2021
User:
Care providers
Care providers
Use this form to request accreditation for a care provider joining your assessment team.
application/pdf — 137.74 KB
Accreditation Request – To add treatment team member
Type:
Downloadable forms
Downloadable forms
Last updated:
November 16, 2021
November 16, 2021
User:
Care providers
Care providers
Use this form to request accreditation for a care provider joining your treatment team.
application/pdf — 143.71 KB
Accreditation Standards and Service Provider Guidelines for Registered Nurses (Nurse Practitioners) (RN(NP)s)
Type:
Publications
Publications
Last updated:
September 1, 2022
September 1, 2022
User:
Care providers
Care providers
Read the accreditation standards and service provider guidelines for nurse practitioners treating WCB customers.
application/pdf — 172.15 KB
Assessment Team Review
Type:
Fact sheets
Fact sheets
Last updated:
October 25, 2020
October 25, 2020
User:
Care providers
Care providers
Read when a care provider can ask for an assessment team review.
application/pdf — 62.64 KB
Audiology’s Billing (AUD)
Type:
Downloadable forms, Online submission forms
Downloadable forms, Online submission forms
Last updated:
October 25, 2020
October 25, 2020
User:
Care providers
Care providers
Use this form for billing the WCB for treating an injured worker.
Billing adjustment example - physical therapists
Type:
Downloadable forms
Downloadable forms
Last updated:
November 17, 2020
November 17, 2020
User:
Care providers
Care providers
View a sample of how to make an adjustment or addition to your invoices.
application/pdf — 447.18 KB
Billing adjustment example – occupational therapists
Type:
Downloadable forms
Downloadable forms
Last updated:
November 17, 2020
November 17, 2020
User:
Care providers
Care providers
View a sample of how to make an adjustment or addition to your invoices.
application/pdf — 459.97 KB
Chiropractor's Initial Report and Physiotherapist’s Initial Report (CHI/PTP) User Manual
Type:
Downloadable forms, Publications
Downloadable forms, Publications
Last updated:
October 25, 2020
October 25, 2020
User:
Care providers
Care providers
Learn how to fill out the Chiropractor's Initial Report (CHI) and the Physiotherapist’s Initial Report (PTI) using the CHI/PTP user manual.
application/pdf — 125.83 KB
Chiropractors' Fee Schedule
Type:
Publications
Publications
Last updated:
November 22, 2021
November 22, 2021
User:
Care providers
Care providers
Use these fee codes and fees to bill for primary level services provided to WCB customers by chiropractors.
application/pdf — 207.78 KB
Chiropractor’s Billing Form (CHRO)
Type:
Online submission forms
Online submission forms
Last updated:
October 25, 2020
October 25, 2020
User:
Care providers
Care providers
Use this form for billing the WCB for treating an injured worker.
Chiropractor’s Initial Report (CHI)
Type:
Online submission forms
Online submission forms
Last updated:
October 25, 2020
October 25, 2020
User:
Care providers
Care providers
Within three days of beginning treatment, you need to forward this form to the WCB detailing your initial findings.
application/pdf — 1.45 MB
Chiropractor’s Progress/Discharge Report (CHP)
Type:
Downloadable forms, Online submission forms
Downloadable forms, Online submission forms
Last updated:
January 28, 2022
January 28, 2022
User:
Care providers
Care providers
This form should be completed after each block of six treatments unless the worker has been discharged, in which case, the CHP should be completed within seven days.
application/pdf — 1.46 MB
Chiropractor’s Progress/Discharge Report (CHP) User Manual
Type:
Downloadable forms
Downloadable forms
Last updated:
December 14, 2020
December 14, 2020
User:
Care providers
Care providers
Learn how to fill out the Chiropractor’s Progress/Discharge Report (CHP) as a chiropractor or physical therapist using the CHP user manual.
application/pdf — 125.08 KB
Client health questionnaire
Type:
Downloadable forms
Downloadable forms
Last updated:
October 25, 2020
October 25, 2020
User:
Care providers
Care providers
Use this questionnaire for the assessment team to get a complete picture of an injured worker’s health.
application/pdf — 973.02 KB
Complex Case - Chiropractors
Type:
Fact sheets
Fact sheets
Last updated:
November 23, 2021
November 23, 2021
User:
Care providers
Care providers
A complex case is one in which the injuries will require more intensive and frequent management by the practitioner and will require more monitoring by the administrative staff at WCB.
application/pdf — 72.5 KB
Dentist’s Initial Report (M7)
Type:
Downloadable forms
Downloadable forms
Last updated:
October 25, 2020
October 25, 2020
User:
Care providers
Care providers
Use this form to provide information about treatment, functional recovery and response to treatment.
application/pdf — 1.13 MB
Direct Deposit Application - Care providers
Type:
Downloadable forms
Downloadable forms
Last updated:
October 25, 2020
October 25, 2020
User:
Care providers
Care providers
Use this form to apply to receive payment for your services by direct deposit.
application/pdf — 116.41 KB
Direct Deposit Application: How to use Adobe Reader to fill your form
Type:
Downloadable forms, Fact sheets
Downloadable forms, Fact sheets
Last updated:
October 25, 2020
October 25, 2020
User:
Care providers, Workers, Employers
Care providers, Workers, Employers
Learn how to use Adobe Acrobat Reader to complete your direct deposit form.
application/pdf — 797.27 KB