Follow the steps to complete the form effectively.

1. Press the ‘Get Form’ button to obtain the C504 questionnaire. This will allow you to access the form and prepare to input the necessary information.
2. Enter your claim number and confirm whether you will be off work due to the injury by checking the appropriate box.
3. Provide your personal information by entering your full name, personal health number, and date of birth.
4. Indicate your job title and describe a typical workday you experience.
5. Specify how long this has been your typical work day and describe any changes that may have contributed to your symptoms.
6. Check all applicable symptoms you are experiencing, and indicate when these symptoms were first noticed.
7. Identify the location of your symptoms and indicate which hand is dominant.
8. List the tasks performed in your job and specify which of these tasks cause or increase your symptoms.
9. Note if your tasks involve any specific movements such as twisting or gripping, and list any tools or equipment used.
10. Document your break schedule and any medical treatments you have received for this condition.
11. Indicate whether you have any existing medical conditions and list any current medications.
12. If applicable, describe any previous injuries to the same body site, and share information about hobbies or activities affected by your injury.
13. Provide additional information regarding your injury and your availability for further contact.
14. Complete the form by signing it, and then determine how you wish to submit it: via fax or mail.
15. Finalize the process by saving changes, downloading, printing, or sharing the completed form as needed.

Complete your C504 WORKER'S PROGRESSIVE INJURY questionnaire online today to ensure a swift response.