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IVAC 228: Rapport médical (crime victims)

The physician following a crime victim or rescuer completes this report for IVAC whenever the nature or expected duration of care changes significantly. It sits between the first Attestation médicale (227) and the Rapport final (229) at consolidation, keeping IVAC informed of the person's condition and treatment. IVAC asks for it to be sent promptly.

Who completes it

The physician providing medical follow-up, or a specialized nurse practitioner (IPS), completes the whole form.

Submitting and payment

How to submit it
Distribute the copies to DGIVAC, the claimant and a third party (Autre), keeping one, and send IVAC's copy promptly online, by fax or by mail.
Who pays
Bill RAMQ code 15796, printed on the form; to be paid directly by IVAC, register as an IVAC supplier.

Good to know

  • A new Rapport médical is due whenever the nature or duration of care changes significantly.
  • The form reproduces the provision of Quebec's workers' compensation act requiring the treating physician to report; the right to recover fees is lost if reports are not made.
  • Later stages use CNESST forms: the REM (2064) when sequelae persist, and the IMCE (2096) when IVAC's physician needs written clarification.
  • The fillable PDF is dated 2019-09 and in French only; IVAC's guide DC200-1007-3 explains how to complete its medical forms.

Get the official form

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

Rapport médical

Medical Report (IVAC)

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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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.

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Frequently asked questions

When is an IVAC Rapport médical required?

Whenever the nature or duration of care for a crime victim or rescuer changes significantly. It follows the first Attestation médicale (227), and the Rapport final (229) closes the medical file at consolidation. Send it to IVAC promptly, online, by fax or by mail, and give the claimant their copy.

What happens if a physician doesn't send IVAC reports?

The form quotes the provision of Quebec's workers' compensation act requiring the treating physician to report to the agency, under which the right to recover fees for the services is lost if the reports are not made. Each report is billed to RAMQ under its own code, 15796 for this one.

Do nurse practitioners complete IVAC medical forms?

Yes. IVAC says specialized nurse practitioners (IPS) complete its medical forms as well as physicians, including the Attestation médicale (227), Rapport médical (228) and Rapport final (229). The forms are French-only fillable PDFs, and IVAC's Guide d'utilisation des formulaires médicaux explains how to complete them.