Forms and guides

Our most-accessed forms are available to be ordered and mailed directly to you from our Order WCB forms page.

Looking for worker or employer forms? Head to the resources section for workers or employers.

General/other

Acupuncturists

Chiropractors

Authorized provider
Non-authorized provider

Dentists and Denturists

Note: Effective January 1, 2023, WCB-Alberta has adopted the current Alberta Dental Association (ADA) dental fee guide for generalists and specialists. WCB-Alberta reimburses dental rates according to this schedule, which outlines rates for different disciplines within the dental industry. When specialist rates are applied, they’re paid at the maximum rate indicated by the ADA fee guide. Please contact the ADA for a copy of the ADA fee guide.

For services provided prior to January 1, 2023, WCB-Alberta utilized the Alberta Blue Cross (ABC) dental fee guide for generalists and specialists. Please contact ABC for a copy of it.

Note: WCB pays denturist fees at the rates set out by the Denturist Association of Alberta (DAA). For information on these rates, please contact DAA.

  • Dental report - C055/C887
    Use this report to summarize your worker’s injury, proposed treatment regimen and prognosis. It can also be used to summarize final findings when your worker is discharged from treatment.
  • Dental guide - C616
    Summarizes treatment authorization and reporting guidelines for dental providers.
  • Denturist guide - C617
    Summarizes treatment authorization and reporting guidelines for denturist providers.
  • Denturist report - C884
    Use this report to summarize your worker’s injury, proposed treatment regimen and prognosis. It can also be used to summarize final findings when your worker is discharged from treatment.
  • TMJ bundled services
    Summarizes the 14799 billing code for TMJ bundled services.

ESL (English as a second language) providers

Hearing aid practitioners/audiologists

Home health care providers

Master level social workers

Nurse practitioners

Occupational Injury Service (OIS)

Our OIS resources page has all the forms and materials you need for your OIS clinic.

Occupational therapists

Accident profiles
Ergonomics
Exposure therapy and cognitive therapy
General assessments
Hand therapy
Home independence and home modification
Hospitals
Incident report
Invoices
Personal care & home equipment
  • OT home equipment assessment - C1176
    Use this form for recommendations for equipment/assistive devices and strategies/education based on the WCB compensable injury, that will allow the worker to maintain independence with self-care and home management activities.
  • OT personal care assessment - C589
    The purpose of the Personal Care Assessment is to determine a worker’s functional ability, personal care, and adaptive equipment needs relative to their work-related injury.
Seating/pressure assessments
Splinting
Vehicle modifications
Wheelchairs

Pharmacists

Physicians

Medical cannabis
  • C1449 Medical Cannabis Management Report.
    This reporting is expected to be completed/submitted by physicians who are prescribing medical cannabis to workers. The reporting should be provided to the worker’s claim every three (3) months at a minimum, or more frequently as recommended by the Standard of Practice on cannabis for medical purposes from the College of Physicians and Surgeons of Alberta.
  • Physicians guide to authorizing cannabinoids for medical purposes
    Refer to the guide when considering prescribing pharmaceutical cannabinoids or authorizing medical cannabis to injured workers.
Physicians
Diagnostic
Opioid management

Physiotherapists

Authorized provider
Non-authorized provider

Prosthetic and orthotic providers

Psychologists and social workers

Electronic reporting is now available for WCB-contracted psychology providers.

Interested in becoming a WCB-contracted provider? Email hcs.psychology@wcb.ab.ca for assistance.

Family or joint counselling

Return-to-work providers

Translators and interpreters