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Alberta AB-4 Concluding Report: Auto Injury Form

This final report closes a course of auto injury treatment in Alberta. The practitioner summarizes visits, progress on functional goals, the reason for discharge or need for ongoing treatment, and the claimant's work status at discharge. It applies to accidents on or after October 1, 2004 and is forwarded to the claimant's insurance company.

Who completes it

Alberta says the AB-4 is completed by the primary health care practitioner who provided the treatment and completed the AB-2, or who completed most of the treatment visits. That practitioner fills in Parts 2 to 7 and the header section, while Part 1 holds the claimant's details.

Submitting and payment

How to submit it
The AB-4 directs that it be forwarded to the insurance company. Under the Automobile Accident Insurance Benefits Regulation (AAIBR), Alberta says the AB-4 is completed at the insurer's request.
Who pays
For the AB-4, fees in the Superintendent of Insurance bulletins apply only to DTPR claims; under the AAIBR, Alberta says expenses for completing AB claims forms are not prescribed and must be reasonable.

Good to know

  • Part 4 (Treatment Summary) asks for the total number of treatments, the dates of the first and last visits, and the total cancelled or missed visits.
  • Part 5 offers reasons including full recovery, partial recovery, plateaued, no progress, transfer to another treatment site, non-attendance, poor compliance and no contact.
  • Part 6 (Discharge Status) records whether the claimant is now working, their employment or training status, and any work or training restrictions.

Get the official form

Download the current version from the source each time; forms change without notice.

Concluding Report

Official pagePDF

Fill it with Vero

Upload the fillable PDF once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.

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How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.

Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.

Frequently asked questions

Who completes the AB-4 if more than one practitioner treated the claimant?

Alberta assigns the AB-4 to the primary health care practitioner who provided the treatment and completed the AB-2 Treatment Plan, or to the one who completed the majority of treatment visits. That practitioner signs Part 7 to certify that the report is true and correct.

What goes in Part 3 of the AB-4?

Part 3, Primary Health Care Practitioner Feedback, records the diagnosis at the initial assessment, key subjective and physical examination findings at the last visit, and progress on up to three functional goals. Each goal is rated from regressed to resolved, with comments on limitations and any further treatment required.