Non-specialist physician's combined first report and invoice for every first visit on a work injury.
- Completed by
- Physician (general practitioner / non-specialist)
- Issued by
- WCB-Alberta
- Format
- Online portal or EMR
- Language
- English
WCB Alberta C914: Medication Management Report
Physicians prescribing opioids for a worker on a WCB-Alberta claim use this one-page report to show whether the medication is improving function and pain; WCB's forms page lists it for out-of-province physicians and Alberta specialists. It covers current complaints, objective findings, medications and doses, function and pain scores, the treatment plan, requests for WCB resources and the worker's work capability.
Who completes it
The prescribing physician completes and signs the whole report, recording the patient's own estimate of average pain over the last week alongside their clinical estimate of function.
Submitting and payment
- How to submit it
- Fax or mail it to WCB-Alberta using the details printed on the form; WCB's opioid policy calls for progress reporting within four weeks of starting long-term opioid therapy and every three months after.
- Who pays
- The report doubles as an invoice to WCB-Alberta, with fields for the WCB billing number, contract ID, health service code, modifiers, calls and encounters.
Good to know
- If function has not improved since opioids were first used, explain the rationale for continuing and state whether the regimen will be adjusted or discontinued.
- You can ask WCB to contact you about the case manager, a Work Assessment Centre referral, an independent medical examination or a WCB physician.
- Work capability is classed as sedentary, light, medium, heavy or very heavy, with any restrictions and an estimated date of return to pre-accident level.
- WCB-Alberta covers opioids only with a single prescriber, generally one long-acting and/or one short-acting opioid, and not by injection outside immediate post-injury, peri-operative or palliative care.
Get the official form
Download the current version from the source each time; forms change without notice.
Medication management report (C914)
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
Who uses WCB Alberta form C914?
WCB-Alberta's forms page lists the Medication Management Report for out-of-province physicians and Alberta specialists prescribing opioids; nurse practitioners have their own version, C914N. The current C914 is a one-page form revised September 2010, with diagnostic code and health service code fields so the visit can be billed.
How often must I report on opioid therapy to WCB Alberta?
Under Policy 04-06, Application 4, the prescriber reports within four weeks of starting long-term opioid therapy and every three months after. Reports cover the dose, typically under 90 morphine equivalents, frequency, baseline and updated function, pain intensity, opioid-related harms and any change to the treatment plan.