Physician's report to WCB PEI for a work-related injury: accident description, clinical findings, diagnosis, work capacity and fee codes.
- Completed by
- Physician
- Issued by
- WCB PEI
- Format
- Fillable PDF
- Language
- English
PEI medical forms for Prince Edward Island clinicians
PEI's 7 verified forms in one place: six WCB PEI reports for physicians, chiropractors, physiotherapists, counsellors and clinics, plus the Social Programs Health Report.
Prince Edward Island has a small section in this library: 7 verified forms, all in English. Six come from WCB PEI, led by the Physician's Report (Form 8), which covers the accident, clinical findings, diagnosis, work capacity and fee codes. Chiropractors and physiotherapists each have a multipurpose report for initial, progress and discharge visits. Counsellors use the Counselling Report (CL-66), and clinics use the Functional Scan (CL-53) and Fit For Work Assessment (CL-54).
The seventh is the Social Programs Health Report, used to establish eligibility for AccessAbility Supports. WCB PEI takes the physician, chiropractor and physiotherapist reports by fax or through its Online Services for health care providers, and doesn't publish its fee schedule. The library lists no PEI auto insurance, drug program or student aid forms yet. Federal forms such as the T2201, CPP disability and EI certificates apply on the Island too and are on the federal hub.
Workers' compensation
All WCB PEI formsChiropractor's multipurpose report (initial assessment, progress, discharge or amended billing): diagnosis, findings, treatment and recommended work status.
- Completed by
- Chiropractor
- Issued by
- WCB PEI
- Format
- Language
- English
Physiotherapist's multipurpose report (initial assessment, progress, discharge or amended billing): diagnosis, findings, treatment and recommended work status.
- Completed by
- Physiotherapist
- Issued by
- WCB PEI
- Format
- Language
- English
CL-53Functional Scan
Serial functional scan (up to four) comparing the worker's maximum ability levels with pre-injury job demands.
- Completed by
- Treating clinic clinician (named on the form)
- Issued by
- WCB PEI
- Format
- Fillable PDF
- Language
- English
Clinic assessment comparing the worker's functional tolerances with the reported job demands (history, MSK exam, functional abilities).
- Completed by
- Clinic-based assessor (regulated health professional named on the form)
- Issued by
- WCB PEI
- Format
- Fillable PDF
- Language
- English
CL-66Counselling Report
Counsellor's periodic report: in-person and virtual treatment dates, symptoms, modalities, response, engagement and psychosocial measures.
- Completed by
- Counsellor or psychologist (mental health provider)
- Issued by
- WCB PEI
- Format
- Fillable PDF
- Language
- English
Disability and income assistance
All Disability assistance formsPractitioner report on medical conditions, employability and disability (impact on ADLs/IADLs). Used to establish eligibility for AccessAbility Supports and, given its employability section, likely other social programs.
- Completed by
- Health care practitioner (medical practitioner)
- Issued by
- PEI Social Development (form header: Department of Social Development & Housing; now Social Development and Seniors)
- Format
- 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.
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Frequently asked questions
How do I submit a WCB PEI Physician's Report?
Print the fillable Form 8 and fax it, or submit it electronically through WCB PEI Online Services for health care providers after signing up. Don't email it, since it holds sensitive information. Enter your fee codes on the form; WCB PEI doesn't publish its fee schedule on its website. WCB PEI doesn't state whether NPs use this form.
What is the PEI Social Programs Health Report used for?
It documents medical conditions, employability and disability, including the impact on daily activities, to establish eligibility for AccessAbility Supports. The practitioner completes Sections 3 to 5 and signs with their registration number. Email a scanned, signed copy to Social Programs with the subject line 'Health Report', or mail or fax it to the regional office listed on the form.
Which WCB PEI forms do physiotherapists and chiropractors use?
Each profession has one multipurpose report, the Physiotherapist Report or the Chiropractor Report, covering initial assessment, progress, discharge or amended billing, with diagnosis, findings, treatment and recommended work status. Neither PDF has fillable fields, but both can be faxed or submitted through WCB PEI Online Services. Clinics doing functional testing use the Functional Scan (CL-53) and Fit For Work Assessment (CL-54).