Get Concluding Report (form Ns-4)

Filing the Concluding Report (Form NS-4) online is an essential step for users involved in an accident on or after April 1, 2013. This guide provides clear, step-by-step instructions to help you complete the form accurately and efficiently.

Follow the steps to complete the Concluding Report (Form NS-4) online.

1. Click ‘Get Form’ button to access the Concluding Report (Form NS-4) and open it in the editor.
2. Begin with Part 1, where you will enter the claimant's information. Include the last name, first name, date of birth, and address details, such as city and postal code.
3. In Part 2, provide the information of the Primary Health Care Practitioner. Make sure to include their name, profession, facility name, contact information, and any relevant dates related to the initial assessment.
4. Move on to Part 3, Assessment Status. Record the diagnosis at the initial assessment, as well as key subjective and physical examination findings from the last visit. List functional goals and assess progress towards these goals.
5. Complete Part 4, Treatment Summary. Here, summarize the treatments provided, including the total number of treatments and dates of visits.
6. In Part 5, state the reason for discharge or the need for ongoing treatment. Indicate whether the claimant has fully recovered, partially recovered, plateaued, or requires further treatment.
7. Fill out Part 6, Discharge Status. Report the date of the last visit, total cancelled or missed visits, and the claimant's current employment status, including any restrictions.
8. Finally, in Part 7, the Primary Health Care Practitioner should sign and date the form, confirming the information provided.
9. After completing the form, save your changes, and choose whether to download, print, or share the form as needed.

Complete your Concluding Report (Form NS-4) online today for a smooth filing process.