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Psychology Assessment Report-only Form pdf
Use this version of the form if you are sending it by secure message attachment
Psychology Progress Invoice and Report Form pdf
Use this version of the form if you are sending it by fax
Psychology Progress Report-Only Form pdf
Use this version of the form if you are sending it by secure message attachment
Primary and Emergency Care Report pdf
This form is completed by physicians or nurse practitioners to report injury details, treatment, and return-to-work status for workers receiving primary or emergency care. Fax completed form to 902-491-8001.
Eye Injury Report pdf
The form is required in order to assess the level of eye impairment, if any, with respect to the worker’s traumatic eye(s) injury(s).
CTS - Physician Hand/Wrist Report pdf
This form is required in order to assess the worker’s claim regarding hand/wrist symptoms being causally related to the workplace.
Service Provider – Assistive Devices Request Form pdf
Form to be completed by service provider for request of assisted devices.
Physician – Assistive Devices Request Form pdf
Form to be completed by physicians for the request of an assistive device.
Audiometric Report pdf
Audiometric report to be completed by service provider.