The SAAQ reports and forms Québec clinicians complete for road-accident victims, driver's licence medical reviews and accessible parking permits.
SAAQ forms cover three areas: road-accident claims, fitness to drive and accessible parking. After a road accident, the physician or specialized nurse practitioner (IPS) completes the Rapport initial et facture (initial report and invoice, form 4065) at the first consultation. The SAAQ may later ask for a Rapport d'évaluation (assessment report, 4066), Rapport d'évolution (progress report, 4067) or Rapport sur les séquelles (after-effects report, 4068). For licence reviews, the general form is the Rapport sur l'état de santé (report on state of health, form 6228).
The SAAQ pays for the initial report up to its maximum even when it did not request it, and reimburses the later reports only when it asked for them. Send them through the SAAQ's online document service, by fax or by mail. English versions, such as 4065A, are reserved for professionals without a Québec address. A health professional who judges a patient unfit to drive can file the Déclaration d'inaptitude à conduire (declaration of unfitness to drive, form 5626).
Rapport initial et facture
First medical report after a road accident, completed at the first consultation following the accident so the victim can claim SAAQ compensation; includes the clinician's invoice.
Rapport d'évolution et reçu ou facture
Progress report on a road-accident victim, sent when the SAAQ requests it, e.g. when recovery differs from what was expected.
Initial Assessment Summary – Psychological Treatment
Completed after the initial psychological evaluation of a road-accident victim, to get the evaluation reimbursed and treatment hours authorized (balise 1).
Follow-up and Progress Summary – Psychological Treatment
Required when the maximum authorized psychology reimbursements will be exceeded: at the 12th treatment hour (balise 2) or the 27th hour (balise 3).
Final Assessment Summary – Psychological Treatment
End-of-treatment summary of psychological treatment for a road-accident victim.
Physiotherapy Progress Report and Invoice
Required when a road-accident victim's private-practice physiotherapy will exceed the reimbursable number of treatments: at the 15th treatment or 9th week (balise 2) and at the 35th treatment (balise 3).
Rapport d'évaluation et reçu ou facture
Report on a road-accident victim's overall health status, completed when the SAAQ asks for it (the SAAQ may send a pre-identified form).
Rapport sur les séquelles et reçu ou facture
Assesses whether a road-accident victim has permanent after-effects (sequelae) from the accident injuries, when the SAAQ requests it.
Dentist's Report
Describes dental damage caused by a road accident, for the victim's SAAQ claim.
Request for Reimbursement of Physiotherapy Costs
Claim used by private-practice physiotherapy clinics to bill the SAAQ for a road-accident victim's treatments.
Request for Reimbursement of Psychology Fees
Claim used by private-practice psychologists/psychotherapists to bill the SAAQ for a road-accident victim's treatments.
Personal Assistance – Grid for Occupational Therapists
OT assessment of a road-accident victim's personal-assistance needs, used by the SAAQ to set the personal-assistance indemnity.
Information médicale complémentaire – Incapacité
Additional medical information the SAAQ may request to assess a road-accident victim's functional limitations/restrictions and ability to work.
Rapport sur l'état de santé – Permis de conduire
General medical report the SAAQ requests to assess a licence holder's or applicant's fitness to drive (vision, hearing, neurological, epilepsy, cardiovascular, respiratory and other conditions).
Déclaration d'inaptitude à conduire un véhicule routier
Used by a health professional to report to the SAAQ a patient they judge unfit to drive.
Rapport d'évaluation fonctionnelle sur l'aptitude physique et mentale à conduire un véhicule routier
Functional driving assessment (including a road test) of a driver's physical and mental fitness, requested by the SAAQ.
Rapport du test routier effectué par un ergothérapeute
Report of an on-road driving test carried out by an occupational therapist for the SAAQ.
5903Rapport d'évaluation médicale sur l'aptitude à la conduite sécuritaire d'un véhicule routier en présence d'un diabète
Medical evaluation of a driver with diabetes (e.g. hypoglycemia risk) requested by the SAAQ.
Rapport d'examen visuel en ophtalmologie ou en optométrie – Santé visuelle – Aptitude à conduire
Eye exam report (acuity, visual field, etc.) requested by the SAAQ to determine whether a driver meets vision standards.
Rapport d'examen médical cardiovasculaire – Permis de conduire
Cardiovascular exam report requested by the SAAQ to assess fitness to drive.
Rapport d'examen médical psychiatrique
Psychiatric exam report requested by the SAAQ to assess fitness to drive.
Rapport d'examen médical neurologique
Neurological exam report requested by the SAAQ to assess fitness to drive (e.g. seizures, stroke, neurodegenerative disease).
Rapport d'examen médical oto-rhino-laryngologique – Permis de conduire
ENT exam report (hearing, vestibular) requested by the SAAQ to assess fitness to drive.
Demande de vignette de stationnement pour personnes handicapées
Application for a disability parking permit; when an evaluation is required, a health professional documents diagnoses, impairments, functional class, type and duration of incapacity, and loss of mobility outdoors.
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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Yes. The SAAQ pays the physician or IPS for the Rapport initial et facture (form 4065) up to its maximum, or reimburses the victim, even when it did not request the report. The invoice is part of the form. The Rapport d'évaluation (4066), Rapport d'évolution (4067) and Rapport sur les séquelles (4068) are reimbursed only when the SAAQ asked for them.
Health professionals who do not have an address in Québec. The SAAQ publishes English versions of its accident reports, from the Initial Report and Invoice (4065A) to the After-Effects Report (4068A), but reserves them for those professionals. Clinicians based in Québec use the French forms. The psychology, physiotherapy and dentist report forms are published in French only.
The person examined. The Rapport sur l'état de santé (form 6228, also numbered 28) says all fees for completing it are paid by the person examined and are not reimbursed by the SAAQ. The SAAQ uses it to assess a licence holder's or applicant's fitness to drive. It is a fillable PDF with an English version (6228A), mailed to the SAAQ's medical evaluation service. The eye exam report (6205) follows the same fee rule.
Only when Section C of the Demande de vignette de stationnement pour personnes handicapées (accessible parking permit application, form 6375) says an evaluation is needed. Some applicants skip it, for example with condition P on their licence or a RAMQ-paid wheelchair. The evaluator, such as a physician, nurse, OT, physiotherapist or another professional listed in Section E, completes Sections D and E. The SAAQ does not reimburse evaluator fees.