Forms and Resources

Forms

Psychology Assessment Invoice and Report Form*

Psychology Assessment Report-Only Form **

Psychology Progress Invoice and Report Form *

Psychology Progress Report-Only Form **

Tiered Services Forms

The Primary and Emergency Care Report

Eye Injury Report 

CTS - Physician Hand/Wrist Report

Assistive Devices Request Form - Service Providers

Assistive Devices Request Form - Physicians

Audiometric Report

Hearing Loss Exception Form

Drug Special Authorization Forms

Dental Claim Form

Centralized Surgical Services Program (CSSP) Referral Form

Occupational Disease Injury Report

Occupational Hearing Loss Injury Report

Occupational Therapist Return to Work (RTW) Plan Form

WCB MGP Exemption Form

Note: Tiered Service Providers are required to submit forms, reports, and invoices through WCB Online for workers with valid NS Health Card Numbers. For more information, visit Tiered Services Forms.

*Use this version of the form if you are sending it by fax

**Use this version of the form if you are sending it by secure message attachment

Reporting and Invoicing

Following invoicing and reporting standards will help ensure timely care for injured workers and their claims.

Learn about reporting and invoicing for service providers

Publications

 

Resources