Premier rapport du chiropraticien
Chiropractor's first report: injury, objective findings, treatment plan and work capacity.
- Completed by
- Chiropractor
- Issued by
- WCB Manitoba
- Format
- Fillable PDF
- Language
- English
Manitoba chiropractors use this one-page form to update the WCB on a worker's recovery after the first report, or at discharge. It records any change in diagnosis, the examination dates since the last report, current complaints and objective findings, consultant referrals, the plan to discharge and work abilities. It is also where a chiropractor requests an extension and gives the rationale.
The treating chiropractor completes and signs the form. Worker details, the area of injury and the date of incident are entered by the clinic, and the worker and employer do not complete any part.
Download the current version from the source each time; forms change without notice.
Upload the fillable PDF 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.
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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WCB Manitoba's service code manual says progress or subsequent reports are not required for every follow-up visit. Send one when the WCB requests it or when there is a notable change in the worker's recovery. The fee under code 0208 is billable only when a completed progress report on the WCB form is submitted.
Yes. The treatment plan section asks whether an extension is requested and for the rationale, alongside the type, frequency and duration of in-clinic treatment to discharge. The WCB guidelines ask for extension requests no later than two weeks before the maximum treatment duration so care is not interrupted.
Criteria include worsening during the first two weeks, no improvement during any consecutive two-week period or six consecutive treatments, and reaching the category's time limit. The WCB then expects discharge, referral elsewhere, or active rehabilitation as the main treatment, with manipulation only as an adjunct.