Forms: Health care providers

Complete and submit a WSIB form

To report a workplace injury or, submit an invoice, functional abilities form or progress report go to TELUS Health. If you are new to TELUS Health, register to bill us and get paid online.

For all other WSIB forms, find the form you need, fill it in using your computer, save it and submit it online.

NEW: You need to sign up for an online services login or sign into your online services account to submit claim documents and WSIB forms.

Categories:

• Report a patient's work-related physical injury or illness
• Update us on your patient's recovery and return to work
• Bill us for your services
• Treatment and programs
  • Programs of care
  • Community mental health program
  • Hearing services program
• Request additional health information
• Request a hearing-related device
• Request treatment extension
• Order forms

Report a patient's work-related physical injury or illness

• Health professional's report – Form 8

  (0008A)

• Health professional's report for occupational mental stress (Form CMS8)

  (0010A)

• ENT consultation report

  (1787A)

• Dental report

  (0278A)

• Physiotherapy assessment report

  (0856C)

Update us on your patient's recovery and return to work

• Functional abilities form for early and safe return to work (2647A)

  (2647A)

• Guide to completing the functional abilities form

   See the fee schedule for the updated functional abilities form fee.

• Health professional's progress report (Form 26)

  (0896A)

• Health professional continuity report (Form REO8)

  (2234A)

• See other commonly used forms.

Bill us for your services

• Register and bill us easily through TELUS Health.

• Provider payment request

  (3947A)

• Provider payment request for equipment/supplies

  (3941A)

Treatment and programs

Programs of care

• Musculoskeletal (MSK) program of care: Initial assessment report (10635A)
• Musculoskeletal (MSK) program of care: Mid-point report (10636A)
• Musculoskeletal program of care: Care and outcomes summary report (10637A)
• Musculoskeletal (MSK) program of care: Supplementary report (10638A)
• Revised program of care for mild traumatic brain injuries Initial assessment report

  (10391A)

• Revised program of care for mild traumatic brain injuries Mid-point report

  (10392A)

• Revised program of care for mild traumatic brain injuries Care outcomes summary

  (10393A)

• Mild traumatic brain injury program of care supplementary report

  (when additional treatment is approved)

Community mental health program

• Community Mental Health Program assessment form

  (0201A)

• Community Mental Health Program Progress Form

  (0203A)

• 0204A Community Mental Health Program RTW Recommendations

  (0204A)

Hearing services program

• Hearing assessment
• Hearing services initial bundle outcome report
• Hearing aid selection change form
• Ongoing hearing services report
• Hearing services mini bundle outcome report

Request additional health information

• Request for hospital medical information

  (1801A)

• Request for hospital medical Information: occupational disease

  (1823A – view only)

• Request for health information

  (2012A – view only)

Request a hearing-related device

• Hearing assistive technologies (HAT) request form

  (10584A)

• Hearing aid replacement and/or clinical exception form

  (10585A)

Request a treatment extension

Note: Do not submit treatment extension requests for anyone being treated in a program of care. Health care providers should call the Clinical Expert Line for case-specific clinical concerns. Read more in the FAQs document for the relevant Program of Care.

• Chiropractor's treatment extension request

  (0148A)

• Physiotherapist's treatment extension request

  (0153A)

Order forms

• Order form for healthcare professionals