Contracted psychology provider's initial counselling report.
- Completed by
- WCB-authorized psychologist or master's-level social worker
- Issued by
- WCB-Alberta
- Format
- Word document
- Language
- English
WCB Alberta C1147: Psychology Counselling Extension
Psychologists and master's-level social workers counselling a worker on a WCB-Alberta claim use this report to ask for more sessions than were authorized. It states the number of additional sessions requested and completed, the rationale, the impact of treatment on return to work with one or two behavioural examples, remaining barriers and an anticipated treatment end date.
Who completes it
The WCB-authorized psychologist or master's-level social worker providing the counselling completes and signs the whole report, including worker, employer, injury and return-to-work details.
Submitting and payment
- How to submit it
- Contracted providers submit extension requests online through myWCB psychology electronic injury reporting, where extensions are reported on the online C852 report; WCB-Alberta also posts C1147 as a Word template.
- Who pays
- The report has its own WCB-Alberta report fee, code PPMR17, which the provider ticks in the billing section.
Good to know
- Give one or two specific behavioural examples of treatment success and explain how the strategies or skills provided have affected the worker's ability to return to work.
- The return-to-work section rates regular schedule, hours, duties, safety-sensitive work and work location, and lists modified work ideas the claim owner will discuss with the employer.
- For virtual sessions, the form records that informed verbal consent for virtual care was obtained and the privacy risks were explained to the worker.
- Related WCB-Alberta forms include the initial (C851), progress (C852) and discharge (C853) counselling reports, the counselling invoice (C1227) and the family counselling extension request (C1416).
Get the official form
Download the current version from the source each time; forms change without notice.
Psychology counselling extension report - C1147
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.
Vero is not affiliated with, or endorsed by, the agencies and insurers listed here. Read our editorial policy.
Frequently asked questions
How do I request more counselling sessions from WCB Alberta?
Complete the counselling extension report with the number of additional sessions requested, the number completed and your rationale, then describe the impact of treatment on return to work, the barriers that remain and an anticipated end date. Contracted providers using myWCB submit extension requests through the online C852 report, which covers progress, extension and discharge.
Can office staff submit counselling reports for me?
They can submit, but not sign. In myWCB the account administrator can create user profiles so staff submit reports and invoices on the clinician's behalf. WCB-Alberta's counselling report guides still require the signature of the clinician who provided the counselling, not a supervising clinician or office staff; a digital signature is accepted.