Newfoundland and Labrador medical forms for clinicians

All 31 verified NL forms: WorkplaceNL reports and invoices, Motor Registration driver medicals, NLPDP special authorization, StudentAidNL, MTAP and accessible parking.

Newfoundland and Labrador has 31 verified forms in this library, all in English. WorkplaceNL accounts for 18, led by the Physician's Report (Form MD) for new injuries, recurrences and significant changes, billed on the physician invoice (Form 92). The Motor Registration Division uses the Drivers Medical Examination Report plus follow-ups such as the Neurology Report Form and Diabetic Questionnaire. Drug coverage runs through the NLPDP Special Authorization Request Form and 25 drug-specific versions.

Form MD is a paper triplicate without fillable fields, and WorkplaceNL pays more for reports sent online through connect. MCP insures the driver exam for non-commercial seniors when it's required because of age; otherwise the driver may pay. Students use StudentAidNL's Verification of Eligibility Form, and MTAP needs a physician's note to cover a non-medical escort. The library lists no NL auto insurance or income support forms yet. Federal forms such as the T2201, CPP disability and EI certificates apply here too and are on the federal hub.

Workers' compensation

All WorkplaceNL forms

Physician's report for new work-related injuries, recurrences, and progress when the worker's condition, treatment or return-to-work status changes significantly. The employer's copy goes to the employer through the worker.

Completed by
Physician
Issued by
WorkplaceNL
Format
PDF
Language
English

Initial, progress or discharge report for clinic-based occupational rehabilitation (CBOR) of a worker.

Completed by
Attending licensed practitioner at a clinic-based occupational rehabilitation provider
Issued by
WorkplaceNL
Format
PDF
Language
English

Counsellor's progress report: treatment modalities, functioning, and the worker's confidence and readiness to return to or stay at work.

Completed by
Counsellor with a WorkplaceNL vendor number (e.g., psychologist, social worker)
Issued by
WorkplaceNL
Format
Fillable PDF
Language
English

Counsellor's initial report: presenting problem, clinical assessment, treatment plan and return-to-work factors.

Completed by
Counsellor with a WorkplaceNL vendor number (e.g., psychologist, social worker)
Issued by
WorkplaceNL
Format
Fillable PDF
Language
English

Treating health care provider's report on a worker's hand injury, including expected time to maximum recovery.

Completed by
Treating health care provider
Issued by
WorkplaceNL
Format
PDF
Language
English

Request to replace a worker's hearing aid(s), with the current device, reason and proposed solution.

Completed by
Hearing aid vendor (audiologist or hearing instrument practitioner)
Issued by
WorkplaceNL
Format
PDF
Language
English

Cover/information sheet sent with occupational rehabilitation service reports (e.g., JSA, WSR, FA, adjustment assessment, WSOR).

Completed by
Licensed practitioner delivering occupational rehabilitation services
Issued by
WorkplaceNL
Format
Fillable PDF
Language
English

Driver medicals and reporting

All Driver medicals forms

Diabetes-specific driver medical (insulin or oral agents, hypoglycemia awareness and episodes, glucose monitoring) requested by Motor Registration.

Completed by
Physician (signature block also allows NP)
Issued by
NL Motor Registration Division
Format
Fillable PDF
Language
English

Routine driver medical (letter with form on the back) against the CCMTA Medical Standards for Driver Fitness, for example for senior or commercial drivers.

Completed by
Physician or NP
Issued by
NL Motor Registration Division
Format
Fillable PDF
Language
English

Seizure/epilepsy and neurological condition report requested by Motor Registration to decide fitness to drive.

Completed by
Physician or NP
Issued by
NL Motor Registration Division
Format
Fillable PDF
Language
English

Update on a driver's cognitive status, requested after MRD receives information about possible memory problems (CCMTA standard, chapter 6).

Completed by
Physician or NP (form says 'health care provider')
Issued by
NL Motor Registration Division
Format
Fillable PDF
Language
English

Eye-care report of visual acuity, lens recommendations and horizontal visual fields for a driver referred by Motor Registration.

Completed by
Ophthalmologist or optometrist
Issued by
NL Motor Registration Division
Format
Fillable PDF
Language
English

General Newfoundland and Labrador Prescription Drug Program request for special authorization drug coverage.

Completed by
Prescriber (separate block for another healthcare professional if different)
Issued by
NL Health and Community Services - Pharmaceutical Services (NLPDP)
Format
PDF
Language
English

Criteria-based special authorization forms for specific drugs or classes: antiplatelet therapy, anti-fibrotic therapy, atopic dermatitis, biologics for asthma, chronic rhinosinusitis with nasal polyps and migraine, chronic plaque psoriasis, oral ciprofloxacin, T2DM high CV risk, hepatitis C, HIV PrEP, IBD, inhalers for asthma/COPD, insulin detemir, LMWH for VTE prevention after surgery, Paxlovid, non-insulin antidiabetics, ophthalmic VEGF inhibitors, phosphate binders, RA initiation and continuation, Tamiflu for LTC residents, blood glucose test strips, topical antipsoriatics, Cabenuva.

Completed by
Prescriber (physician or other healthcare professional; some have an optional pharmacist block)
Issued by
NL Health and Community Services - Pharmaceutical Services (NLPDP)
Format
PDF
Language
English

Physician letter, on physician or hospital letterhead, stating why a patient needs a non-medical escort to reach a specialized medical service. MTAP needs it to cover escort travel.

Completed by
Physician (MTAP claim forms say escorts must be supported by documentation from a physician or nurse practitioner)
Issued by
NL Labrador Affairs - Medical Transportation Assistance Program (MTAP)
Format
PDF
Language
English

Parking, paratransit and travel

All Parking, paratransit and travel forms

Application for GoBus paratransit in St. John's and Mount Pearl; the clinician documents the disabilities and health conditions affecting use of Metrobus.

Completed by
Health care professional such as a family physician, social worker, physiotherapist, mental health professional or OT
Issued by
Metrobus Transit (St. John's)
Format
PDF
Language
English

Billing and invoices

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

How do I submit WorkplaceNL Form MD?

Fax the paper triplicate, or submit online through WorkplaceNL's connect portal, which pays a higher reporting fee. Section B uses the codes on the code sheet for body parts, findings, diagnoses and treatments. Stamps aren't permitted on the triplicate, and incomplete or illegible reports aren't paid. The employer's copy shows only the red-outlined sections and reaches the employer through the worker.

Who pays for a driver medical in Newfoundland and Labrador?

MCP insures the Drivers Medical Examination Report for non-commercial senior drivers when the exam is required because of age. Otherwise the driver may be responsible for the cost, and the Update Cognitive Function form states that the driver pays. Physicians and NPs can complete the exam, and the Motor Registration Division accepts it by fax, email or mail.

Which NLPDP special authorization form should I use?

Check the 25 drug-specific forms first. They cover areas such as non-insulin antidiabetics, inflammatory bowel disease, inhalers for asthma and COPD, hepatitis C, HIV PrEP and Paxlovid. If none applies, use the standard Special Authorization Request Form, which has no fillable fields. Fax or mail the form to NLPDP Pharmaceutical Services as printed on it.

Do Newfoundland and Labrador students need a disability form for student aid?

Yes. StudentAidNL's Verification of Eligibility Form for Students with Disabilities verifies a permanent or persistent/prolonged disability for integrated student financial assistance. A qualified medical or educational assessor completes Section C and certifies in Section D. A learning disability also needs a psycho-educational assessment. The form goes to Student Financial Services by email, fax or mail.