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Me) Address Street (Initial) (First Name) City/Town (Postal Code) Province Telephone Number ( ) Note: WCB requires a personal attendant's Social Insurance Number in order to process T4A slips The above named personal attendant is required to assist a WCB claimant to attend an appointment (i.e. medical examination, DRDRB review meeting or appeal hearing) in relation to their claim. WCB can pay a wage loss allowance if the personal attendant has a loss of earnings as a result of leaving wo.

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