Get Canada C019 2020

The Canada C019 form is crucial for submitting invoices for physical therapy services. This guide provides users with clear, step-by-step instructions on how to complete the form online, ensuring all necessary information is accurately filled out.

Follow the steps to successfully complete the Canada C019 form online.

1. Press the ‘Get Form’ button to access the Canada C019 form, allowing you to fill it out online with ease.
2. Enter the WCB claim number in the designated field.
3. Input the date of the accident in the specified format (yyyy/mm/dd).
4. Fill in your surname, first name, and initial clearly.
5. Provide your date of birth in the format (yyyy/mm/dd).
6. Include your complete address, specifying the street, city/town.
7. Enter your telephone number for contact.
8. In the service items section, list the date of service (yyyy/mm/dd) for each item.
9. Fill in the health service code for each service provided.
10. Describe each service accurately.
11. Indicate the quantity of service items being billed.
12. Specify the rate per unit for each service.
13. Calculate and include the total amount billed for each item.
14. For sundry items, repeat steps 8-13, ensuring all information is clearly filled in.
15. In the payment details section, provide the name and address of the individual or organization to whom the fee is payable.
16. Enter the provider name along with the WCB billing number.
17. Provide your telephone number and fax number.
18. Include your provider reference number.
19. Enter the date in the format (yyyy/mm/dd) at the bottom of the form.
20. Review all fields for accuracy, then save your changes, and proceed to download, print, or share the completed form as needed.

Complete the Canada C019 form online today to ensure your physical therapy services invoices are submitted correctly.