Initial, progress and discharge reports for WCB-authorized home health care services.
- Completed by
- Home health care nurse / provider
- Issued by
- WCB-Alberta
- Format
- Word document
- Language
- English
WCB Alberta C709: On-Site Health Centre Report
Workplace on-site health centres use this one-page report to tell WCB-Alberta about a worker they treated for a work-related injury. The form states it collects information from on-site health care providers who are not medical doctors, covering how the injury happened, the worker's complaint, any physician referral, and whether the worker can do date-of-accident or modified work.
Who completes it
The on-site provider who gave the treatment completes and signs the report with their professional designation or skill code, and names the organization they provide the service for.
Submitting and payment
- How to submit it
- Fax or mail the report to WCB-Alberta using the details printed at the top of the form, including the WCB claim number if one exists.
Good to know
- Give the worker's personal health number; the social insurance number is requested only when no personal health number is available.
- Record the name of the person giving treatment, the date and time of treatment, the date of injury, the part of body and any relevant past history.
- The work section asks whether the injury prevents date-of-accident work, whether permanent impairment is anticipated, any work restrictions and an estimated return to pre-accident level.
- Physicians use WCB-Alberta's physician first report (C050) instead; C709 asks only whether the worker was referred to a physician and to whom.
Get the official form
Download the current version from the source each time; forms change without notice.
On-site health centre report - C709
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 the WCB Alberta On-Site Health Centre Report?
Health care providers working in a workplace on-site health centre who are not medical doctors. The form identifies the provider by professional designation or skill code and asks for whom the service is provided. Physicians treating an injured worker report to WCB-Alberta on their own physician reports instead.
What does C709 ask about return to work?
Whether the injury prevents the worker from performing their date-of-accident work, whether permanent impairment is anticipated, whether modified or alternate work can be done, a description of work capability, any work restrictions, and an estimated date of return to pre-accident level. The current version is C-709 REV DEC 2023.