Get Acupuncture Receipt

Filling out the Acupuncture Receipt online is a straightforward process. This guide provides clear and concise instructions on each component of the form to ensure you complete it accurately and efficiently.

Follow the steps to complete your Acupuncture Receipt online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by entering the WCB claim number at the top of the form. This number is essential for processing your claim effectively.
3. Next, fill in your Personal Health Number. Ensure it is printed clearly to avoid any confusion.
4. Enter the patient's surname, first name, and initial in the designated fields.
5. Provide the full address including street, city or town, province, and postal code to ensure accurate billing.
6. Specify the part of the body that requires treatment, and detail the type of injury sustained.
7. Input a valid telephone number that can be reached for any follow-up queries.
8. Document the date of the accident and the date of service in the required format (Year / Month / Day).
9. Include the date of birth of the patient to help verify their identity.
10. Select the type of service provided and enter the fee submitted for that service.
11. If applicable, fill out any additional treatment details in the provided blank spaces, specifying each service provided.
12. Calculate and write the total amount billed at the bottom of the document. This is crucial for billing accuracy.
13. Indicate if this is a final treatment or ongoing treatment to clarify the billing process.
14. The document must be accompanied by a Progress or Discharge Report, so ensure this is prepared in advance.
15. Provide the name and address to whom the fee is payable, along with their telephone and fax numbers.
16. Finally, print your name, provide the WCB billing number if applicable, sign, and date the form before submission.

Complete your Acupuncture Receipt online today for seamless processing.