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WCB Alberta Home Health Care Reports (C1470-C1474)

Home health care providers working on WCB-Alberta claims use this set of Word reports to assess a worker's home care needs and follow them to discharge: an initial report (C1470), long-term (C1471) and short-term (C1472) progress reports, and long-term (C1473) and short-term (C1474) discharge reports. The claim owner uses them, with policy, to decide eligibility for benefits.

Who completes it

A registered nurse signs the initial report, and an RN or LPN nurse assessor completes the progress and discharge reports, which record who completed them.

Submitting and payment

How to submit it
Send completed reports to WCB-Alberta by fax or email using the contact details printed on the forms; supplies are requested on C726 and services invoiced on C641 with the C1304 monthly summary.
Who pays
WCB-Alberta pays a report fee on each, coded HM11A on the initial report and HM13A on the long-term progress and short-term discharge reports.

Good to know

  • Recommendations must rest on an objective nursing assessment and clinical findings, without subjective reports or opinions on compensability or benefit entitlement.
  • The initial report records whether its contents were reviewed with the claim owner and whether the claim owner authorized the treatment plan.
  • Eleven categories are rated recovered, improving, worsening or unchanged, including functional status, skin and wounds, medications, cognition, psychosocial factors, home environment and safety.
  • Services are set out by RN, LPN or health care aide with hours and date ranges, and progress reports ask about cancellations, incidents and reviews of the C1467 responsibilities form.

Get the official form

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

Home health care reports

Official page

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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

Which WCB Alberta home health report do I use?

Start with the initial report (C1470) after the nursing assessment. For ongoing care, use the long-term (C1471) or short-term (C1472) progress report, and at the final visit the long-term (C1473) or short-term (C1474) discharge report. All are Word templates listed under home health care providers on WCB-Alberta's forms page.

What other forms go with WCB Alberta home health reports?

The roles and responsibilities form (C1467), with a signed copy attached to the initial report once it is reviewed with the worker; the consent form (C1469); the supply form (C726); the travel plan authorization (C727B); the incident report (C921); and the invoice (C641) with its monthly summary (C1304).