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
  • Non-surgical fracture episode of care
  • Community mental health 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)
  • Guide to completing the functional abilities form

Fee schedule for the updated functional abilities form fee.

• Health professional's progress report (Form 26) view only
  (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 program of care: initial assessment report (2345A)(pdf, in use until April 30, 2023)
• Non-surgical fracture episode of care Initial assessment report (2610A)(pdf, in use until April 30, 2023)
• Non-surgical fracture episode of care summary report (2611A)(pdf, in use until April 30, 2023)
• Shoulder program of care initial assessment (2522A)(pdf, in use until April 30, 2023)
• Shoulder program of care – care and outcomes summary (2524A)(pdf, in use until April 30, 2023)
• Care and outcomes summary (discharge form) (2339A)(pdf, in use until April 30, 2023)
• Program of care for low back injuries: care and outcomes summary (3239A)(pdf, in use until April 30, 2023)
• Program of care for low back injuries: initial assessment report (3238A)(pdf, in use until April 30, 2023)
• 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
• Musculoskeletal (MSK) program of care: Supplementary report (10638A)
• Program of care NIHL hearing aid outcome report
  (0037A2)
• 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)

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 or Episode 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
  (1904C)