Documents mental health treatment outcomes and recommended next steps at the end of treatment.
- Completed by
- Health care practitioner (mental health)
- Issued by
- Alberta Treasury Board and Finance (Care-First)
- Language
- English
Alberta AB-5 Referral to Injury Management Consultant
When an Alberta auto injury claimant needs another opinion, the primary health care practitioner uses this referral to send the case to an Injury Management Consultant, another primary health care practitioner or another professional. It explains why the claimant is being referred and passes on the injury, investigations and treatment to date. Copies go to the insurance company and the practitioner receiving the referral.
Who completes it
The primary health care practitioner who is requesting the consult completes Parts 2 to 7 and the header with the insurer, policy number and claim number. Part 1 holds the claimant's information.
Submitting and payment
- How to submit it
- The form directs that it be forwarded to the insurance company and to the health care practitioner receiving the referral. It is a dynamic XFA PDF that needs Adobe Reader.
- Who pays
- For the AB-5, 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 (Reason for the Referral) asks whether the opinion is requested for a definitive diagnosis or for treatment, with supporting details.
- Part 6 lists enclosed information such as the consent form and reports of investigation, including laboratory analysis, diagnostic imaging or other reports.
- Alberta's forms page lists it as the Referral to Injury Management Consultant Form, while the printed title is simply Referral (Form AB-5).
Get the official form
Download the current version from the source each time; forms change without notice.
Referral
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.
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 can a claimant be referred to on an Alberta AB-5?
The form offers three choices: an Injury Management Consultant, a primary health care practitioner, or other. Part 3 records the details of the professional to whom the claimant is being referred, and the referring practitioner explains the reason in Part 4 and the investigations and treatment to date in Part 5.
Which accidents does the AB-5 apply to?
The AB-5 is printed for accidents that occur on or after October 1, 2004 and carries revision AB0005 Rev. 2017-04. Alberta's new Care-First auto insurance system, starting January 1, 2027, introduces a separate set of forms for health care practitioners.