Saskatchewan dentists complete this one-page WCB report when a work injury damages a worker's teeth or dentures. It documents how the injury happened, who gave first treatment, the damage, a tooth chart and any other oral condition, then a treatment plan and itemized estimate. Emergency dental treatment is paid at a reasonable rate, but the remaining services need WCB authorization before treatment goes ahead.
The treating dentist completes, prints and signs the whole form, adding the clinic number, provider number and payee code. The form itself was approved by the College of Dental Surgeons of Saskatchewan.
Download the current version from the source each time; forms change without notice.
Dentist's Initial Report (M7)
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Yes. The M7 states that emergency dental treatment will be paid for at a reasonable rate. Authorization for the remaining dental services must be obtained from the WCB before proceeding with treatment, which is why the form asks for a detailed treatment plan and an itemized estimate.
Item 9 asks you to itemize charges using the College of Dental Surgeons of Saskatchewan Fee Schedule, then add an approximate lab fee and the total. The estimate and the item 8 treatment plan support the authorization the WCB must give before non-emergency dental work goes ahead.
The header asks for the WCB claim number, firm number and rate code, the injury date, Provincial Health Number and date of birth, the worker's and employer's names and addresses, and your clinic and provider numbers. Dates are written month first (MM/DD/YYYY), and the form asks you to print and sign it before mailing or faxing.