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WSIB MSK Program of Care Mid-Point Report (10636A)

At the end of block one of the WSIB musculoskeletal program of care, the treating professional reports progress on this four-page form. It records sessions provided, response to treatment, recovery barriers, return-to-work goals for block two and updated abilities and restrictions, including changes since the initial assessment. Entitlement must be confirmed before the person proceeds to block two, and the WSIB holds block one payment until this report arrives.

Who completes it

The registered regulated health professional delivering the program, such as a physiotherapist or chiropractor, completes and signs the whole report.

Submitting and payment

How to submit it
Submit it online at wsib.ca/submit within two business days of the last block one treatment, and bill it electronically through TELUS Health.
Who pays
Bill the report under MPOCMPF; block two is billed separately under MPOCSB2 (single zone) or MPOCMB2 (multiple zones), and needs at least four visits for the full block fee.

Good to know

  • If the person is discharged during or after block one, skip this report and submit the care and outcomes summary (10637A) instead.
  • Block one payment is withheld until the WSIB has received both the initial assessment and mid-point reports and their billing.
  • Response to treatment is rated from fully recovered from the workplace injury through significant, minimal or no improvement to worsening, with details.
  • Use the date of the first treatment visit in a block as the service date, and enter the number of visits as units when billing.

Get the official form

Download the current version from the source each time; forms change without notice.

Musculoskeletal (MSK) program of care: Mid-point report

Rapport de mi-parcours dans le cadre du Programme de soins musculo-squelettiques

Official pagePDFVersion française

Fill it with Vero

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.

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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

When do I submit the WSIB MSK mid-point report?

At the end of block one, within two business days of the last block one treatment. The form states that entitlement must be confirmed to proceed to block two. If the person is discharged during or after block one, a care and outcomes summary replaces the mid-point report.

Is the MSK mid-point report needed if my patient is discharged early?

No. The MSK fee schedule says that if the patient is discharged during or after block one, you complete and submit a care and outcomes summary report (10637A), and a mid-point report is not needed. That summary records whether the person completed the program or did not return.

Is Form 10636A available in French?

Yes. The French version is the Rapport de mi-parcours dans le cadre du Programme de soins musculo-squelettiques (10636B), and the English form notes that it is available in French. Submit either version online through wsib.ca/submit within the two-business-day deadline.