Get Pt Intake Report Form A - Wcb Ns

Filling out the PT Intake Report Form A - Wcb Ns online can streamline the process of reporting a worker's injury and related health information. This guide provides clear, step-by-step instructions to help you navigate the form's sections with confidence.

Follow the steps to successfully complete the PT Intake Report Form A - Wcb Ns online.

1. Click the ‘Get Form’ button to access the form and open it in your preferred editor.
2. Begin by entering the WCB claim number and health card number at the top of the form. These identifiers are essential for processing the report.
3. In the 'Worker Information' section, provide the worker's last name, first name, initial, address, city or town, province, street, postal code, and contact numbers (home/cell and work). Also, include the date of injury and the worker’s date of birth.
4. Indicate whether the worker is currently working by selecting 'Yes' or 'No.' This information helps to evaluate the impact of the injury.
5. Next, fill in the 'Employer Information.' If possible, include the employer's name, contact person, and their phone number. Also, indicate whether a WCB accident report has been filed and provide relevant firm and job title information.
6. In the 'Injury Information' section, detail the mechanism of injury, specify the physiotherapy diagnosis, and indicate if the injury prevents the worker from performing pre-injury work or transitional duties.
7. Complete the 'Initial Job Match Summary' by describing the pre-injury job requirements, the present work capability, and transitional duties if applicable. Select the appropriate physical effort classifications based on the worker’s ability.
8. In the 'Health Care Provider Information' section, provide the name of the clinic, ID number, the name of the practitioner, and their contact details (phone and fax).
9. Finally, double-check all entered information for accuracy. Once satisfied, you can save changes to the form, download it, print a hard copy, or share it as necessary.

Complete your PT Intake Report Form A - Wcb Ns online today for a smooth reporting process.