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 Occupational Therapy Contract Forms
WCB-Alberta posts about 20 Word templates for contracted occupational therapists, one for each service they deliver on a claim. They include the pre- and post-accident profile (C977), ergonomic assessment (C1162), cognitive therapy (C1417 to C1419), prolonged exposure therapy (C1164 to C1166), specialized assessment (C1260) and reassessment (C1313), hand therapy (C1167 to C1169), home, seating, splinting, vehicle and mobility assessments, and a reintegration and return-to-work planning tool (C1538).
Who completes it
The contracted occupational therapist delivering the service completes and signs the matching template; several record the compensable and non-compensable conditions from the referral and whether care was in person or virtual.
Submitting and payment
- How to submit it
- Send completed reports to WCB-Alberta by fax or email using the contact details printed on each template; the specialized assessment (C1260) is due within five business days of the assessment.
- Who pays
- Services and reports are invoiced to WCB-Alberta on the OT invoice (C950), whose legend lists service codes billed in 15-minute units, such as COT51 for a specialized assessment report and COTR02 for a reassessment report.
Good to know
- Functional findings on the specialized assessment must rest on the compensable injury and observation of the worker, not subjective reports alone, and each recommendation needs evidence-based rationale.
- The reintegration and return-to-work planning tool (C1538) is for planning, not for assessing fitness for work, and WCB expects the OT to lead reintegration sessions in person.
- The pre- and post-accident profile (C977) compares the worker's self-report, the claim file and interviews with other sources, flagging inconsistencies; consent form HC-693 goes with it.
- WCB-Alberta's forms page notes that the occupational therapy contract reference guides are being updated and will be posted when complete.
Get the official form
Download the current version from the source each time; forms change without notice.
Occupational therapy contract report forms
Get the note ready with Vero
This form is a Word template, not a PDF. Vero Scribe writes the visit note it draws on, so the details are ready when you complete it.
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
Where do I find WCB Alberta occupational therapy report forms?
On WCB-Alberta's forms and guides page under occupational therapists, grouped by service: accident profiles, ergonomics, prolonged exposure and cognitive therapy, specialized assessment, hand therapy, home independence and modification, home equipment, seating, splinting, vehicle modifications and wheelchairs. Each is a Word template, and an OT incident report (C1444) is posted too.
When is the WCB Alberta OT specialized assessment report due?
Within five business days of the assessment. The C1260 template asks you to confirm whether you met that timeline and, if not, explain why. It also records whether the assessment was discussed with the claim owner before submission and whether a reassessment, reported on C1313, is recommended.