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
Auto insurance medical forms for clinicians, province by province
The forms clinicians complete for motor vehicle injury claims in BC, Alberta, Saskatchewan, Manitoba, Ontario and Québec, including Alberta's new Care-First forms.
Auto insurance medical forms differ by province. In BC, ICBC's CL489 reports cover family physicians and allied health providers. Québec's SAAQ starts with the Rapport initial (form 4065), and Ontario uses FSRA's OCF forms, including the OCF-18 and OCF-23. Manitoba's MPI publishes therapy and chiropractic reports for PIPP claims, and Saskatchewan's SGI attaches permanent impairment forms to its request letters. Alberta uses the AB series, such as the AB-1A disability claim and the AB-2 Treatment Plan.
Alberta is changing. Its Care-First auto insurance system begins January 1, 2027, with new practitioner forms such as the Program of Care Initial Assessment, the Initial Assessment and Care and Treatment Request, and progress and concluding reports. When we checked, none had a form number or downloadable template yet. The current AB forms are dynamic XFA files that open only in Adobe Reader, not in a browser or on mobile. ICBC, SAAQ and Ontario OCF forms each have their own page.
Find your province’s forms
Alberta
Documents treatment outcomes and recommended next steps at the end of customized physical treatment.
- Completed by
- Health care practitioner
- Issued by
- Alberta Treasury Board and Finance (Care-First)
- Language
- English
Updates mental health recovery progress, treatment response and changes in treatment needs.
- Completed by
- Health care practitioner (mental health)
- Issued by
- Alberta Treasury Board and Finance (Care-First)
- Language
- English
Updates physical recovery progress, treatment response and changes in treatment need.
- Completed by
- Health care practitioner
- Issued by
- Alberta Treasury Board and Finance (Care-First)
- Language
- English
Requests insurer approval of a customized physical treatment plan (does not establish a diagnosis).
- Completed by
- Health care practitioner
- Issued by
- Alberta Treasury Board and Finance (Care-First)
- Language
- English
Initial assessment for claims with both Program of Care-eligible injuries and injuries needing a Care and Treatment Request for customized treatment.
- Completed by
- Health care practitioner
- Issued by
- Alberta Treasury Board and Finance (Care-First)
- Language
- English
Insurer-initiated assessment of accident-related ability to perform ADLs/IADLs to determine the Daily Living Assistance benefit.
- Completed by
- Health care practitioner (insurer-initiated)
- Issued by
- Alberta Treasury Board and Finance (Care-First)
- Language
- English
Mental health assessment, diagnosis and recommended customized treatment plan; insurer must approve before treatment begins.
- Completed by
- Health care practitioner (mental health)
- Issued by
- Alberta Treasury Board and Finance (Care-First)
- Language
- English
Physical assessment, diagnosis and recommended customized treatment plan; insurer must approve before treatment begins.
- Completed by
- Health care practitioner
- Issued by
- Alberta Treasury Board and Finance (Care-First)
- Language
- English
Findings of an independent multidisciplinary Care-First medical assessment.
- Completed by
- Primary medical assessor
- Issued by
- Alberta Treasury Board and Finance (Care-First)
- Language
- English
Documents functional status, injury impacts, diagnosis, treatment needs and eligibility for the Care-First Program of Care.
- Completed by
- Health care practitioner
- Issued by
- Alberta Treasury Board and Finance (Care-First)
- Language
- English
Documents functional status, treatment response and progress on outcome measures after six weeks of Program of Care treatment.
- Completed by
- Health care practitioner
- Issued by
- Alberta Treasury Board and Finance (Care-First)
- Language
- English
Documents functional status and outcome-measure progress at the conclusion of the Program of Care.
- Completed by
- Health care practitioner
- Issued by
- Alberta Treasury Board and Finance (Care-First)
- Language
- English
Insurer-initiated objective range-of-motion measurement used to assess permanent loss of movement and permanent impairment eligibility.
- Completed by
- Health care practitioner (insurer-initiated)
- Issued by
- Alberta Treasury Board and Finance (Care-First)
- Language
- English
Insurer-initiated documentation of scarring or other lasting physical changes for permanent impairment eligibility.
- Completed by
- Health care practitioner (insurer-initiated)
- Issued by
- Alberta Treasury Board and Finance (Care-First)
- Language
- English
Health care practitioner documents service costs for payment or reimbursement under Care-First.
- Completed by
- Health care practitioner
- Issued by
- Alberta Treasury Board and Finance (Care-First)
- Language
- English
Claimant applies for Section B disability income benefits and a physician certifies the disability.
- Completed by
- Physician
- Issued by
- Alberta Superintendent of Insurance (Treasury Board and Finance)
- Format
- Fillable PDF
- Language
- English
AB-2Treatment Plan
Primary health care practitioner reports status and the treatment plan for sprain/strain/WAD injuries under the Diagnostic and Treatment Protocols Regulation; only listed treatment is pre-authorized.
- Completed by
- Primary health care practitioner (physician, chiropractor or physical therapist)
- Issued by
- Alberta Superintendent of Insurance (Treasury Board and Finance)
- Format
- Fillable PDF
- Language
- English
AB-3Progress Report
Primary health care practitioner reports the claimant's recovery progress (typically when the insurer requests it).
- Completed by
- Primary health care practitioner
- Issued by
- Alberta Superintendent of Insurance (Treasury Board and Finance)
- Format
- Fillable PDF
- Language
- English
Primary health care practitioner reports treatment summary, discharge status and any need for ongoing treatment at the end of DTPR care.
- Completed by
- Primary health care practitioner
- Issued by
- Alberta Superintendent of Insurance (Treasury Board and Finance)
- Format
- Fillable PDF
- Language
- English
AB-5Referral
Primary health care practitioner refers the claimant to an Injury Management Consultant (or other practitioner) with injury, investigation and treatment details.
- Completed by
- Primary health care practitioner
- Issued by
- Alberta Superintendent of Insurance (Treasury Board and Finance)
- Format
- Fillable PDF
- Language
- English
Certified examiner gives an opinion on whether the claimant's injury is a minor injury under the Minor Injury Regulation.
- Completed by
- Certified examiner (health professional on the Superintendent's Certified Examiner Register)
- Issued by
- Alberta Superintendent of Insurance (Treasury Board and Finance)
- Format
- Fillable PDF
- Language
- English
Saskatchewan
Customer's practitioner describes scarring (location, description, type, length, width) for SGI's permanent impairment benefit assessment.
- Completed by
- Customer's practitioner
- Issued by
- SGI
- Format
- Sent for each case
- Language
- English
Physiotherapist or occupational therapist records active range-of-motion measurements for SGI's permanent impairment assessment.
- Completed by
- Physiotherapist or occupational therapist (customer's choice)
- Issued by
- SGI
- Format
- Sent for each case
- Language
- English
Manitoba
Physiotherapist or athletic therapist's initial report on a PIPP injury claimant (symptoms, signs, outcome measures, diagnosis, injury category, work status).
- Completed by
- Physiotherapist or athletic therapist
- Issued by
- MPI
- Format
- Fillable PDF
- Language
- English and French
Physiotherapist or athletic therapist's follow-up report on treatment response and status for a PIPP claimant.
- Completed by
- Physiotherapist or athletic therapist
- Issued by
- MPI
- Format
- Fillable PDF
- Language
- English and French
Physiotherapist or athletic therapist's discharge report at the end of PIPP-funded treatment.
- Completed by
- Physiotherapist or athletic therapist
- Issued by
- MPI
- Format
- Fillable PDF
- Language
- English
18-019-416Chiropractic Report
Chiropractor's health care report on a PIPP injury claimant, including work-capacity assessment and patient authorization.
- Completed by
- Chiropractor
- Issued by
- MPI
- Format
- Fillable PDF
- Language
- English
More Canadian forms
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
What forms come with Alberta's Care-First auto insurance?
Alberta's Care-First system begins January 1, 2027. The government's forms overview for health care practitioners names a Program of Care Initial Assessment with Phase 1 and Phase 2 reports, Initial Assessment and Care and Treatment Requests for physical and mental health, progress and concluding reports, a Daily Living Assistance assessment, range of motion and scarring assessments, and a Medical Assessor's Report. None had a form number or public template when we checked.
Which Alberta auto insurance forms do practitioners use now?
The Superintendent of Insurance's AB series. A physician certifies disability on the AB-1A for Section B disability income benefits. For sprain, strain and WAD injuries, the primary health care practitioner (physician, chiropractor or physical therapist) uses the AB-2 Treatment Plan, AB-3 Progress Report, AB-4 Concluding Report and AB-5 Referral. Certified examiners give minor injury opinions on the MI-3. All are XFA forms that need Adobe Reader.
Does SGI have a standard medical report form?
No public one. SGI's site says doctors, physiotherapists, chiropractors or nurse practitioners must report the cause and nature of injuries, and practitioners must give SGI a written report within six days of a written request, but no standard report form is published. For permanent impairment benefits, SGI attaches its Range of Motion Charts or its Permanent Impairment Description form to the request letter.
Which MPI forms do therapists and chiropractors use?
Physiotherapists and athletic therapists use MPI's Initial Therapy Report, Subsequent Therapy Report and Therapy Discharge Report for PIPP injury claimants. Chiropractors use the Chiropractic Report (18-019-416), which includes a work capacity assessment and a patient authorization. All four are fillable PDFs, and the initial and subsequent therapy reports also come in French as Word documents. MPI pays at its published provider rates.