Physiotherapist's first (assessment) report on a worker.
- Completed by
- Physiotherapist
- Issued by
- WCB-Alberta
- Format
- Fillable PDF
- Language
- English
WCB Alberta Hospital PT, Hand Clinic and OT Reports
Hospital-based therapists treating workers on WCB-Alberta claims report on five PDFs: physical therapy assessment (C823) and status/discharge (C824/C825), hand clinic assessment (C829) and progress/discharge (C830/C831), and occupational therapy assessment, progress and discharge (C826/C827/C828). Each records objective findings, goals and treatment dates, current work capability and restrictions, and the next step in care.
Who completes it
Hospital physical therapists complete C823 to C825, hand clinic therapists complete C829 to C831, and hospital occupational therapists complete C826 to C828, each signing as the provider.
Submitting and payment
- How to submit it
- Fax or mail each report to WCB-Alberta using the details printed on it; the physical therapy forms carry copy labels for WCB, the physician and the physical therapy clinic.
- Who pays
- Hospital therapy services are billed to WCB-Alberta on the outpatient hospital account (C012), and each report names the payee for the fee.
Good to know
- The physical therapy forms include a triage rating from 1 to 5, and the assessment report asks for the worker's National Occupational Classification (NOC) code.
- Hand clinic reports record Jamar grip in five positions, key, tripod and tip pinch, total active and passive motion per digit, volumetry, and Tinel's and Phalen's tests.
- Work capability is rated heavy, medium, light, limited or not capable, with frequency from never to constant; page 2 of the forms defines each level by force exerted.
- The OT report can recommend a Work Assessment Centre referral for further medical assessment, functional capacity evaluation, occupational rehabilitation or an onsite hand assessment.
Get the official form
Download the current version from the source each time; forms change without notice.
Hospital physiotherapy, hand clinic and occupational therapy reports
Fill it with Vero
If your copy of the form is a fillable PDF, upload it 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.
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 form does a hospital hand clinic use?
C829 for the initial hand clinic assessment, and C830 or C831 (one PDF where you tick progress or discharge) for later reports. Both were revised June 2023 and end with a plan: further hand clinic care such as splinting or wound care, or referral to community physiotherapy, a community hand therapist, further medical intervention or a return-to-work assessment.
What do the hospital physical therapy status and discharge reports ask?
C824 (status) and C825 (discharge) share one PDF. They ask for treatments and dates over four weeks, functional status and objective measures, whether critical job demands are met, a single current status such as employed at modified level or recommend Work Assessment Centre, further therapy weeks, surgery and work restrictions.