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Yukon WSCB forms for doctors, therapists and psychologists

Report forms Yukon health care providers send to the Workers' Safety and Compensation Board, from the doctor's first report to physiotherapy and psychology reports.

The Yukon Workers' Safety and Compensation Board (WSCB) handles workers' compensation in Yukon. Physicians complete the Doctor's first report (F-0043), with findings, diagnosis, treatment plan and follow-up, then the Doctor's progress report (F-0042). The Functional abilities form (F-0044) sets out what the worker can and cannot do, so the employer can accommodate an early, safe return to work. Physiotherapists, chiropractors, psychologists, massage therapists, dentists and hearing service providers each have their own reports.

Yukon providers must report treatment of a work-related injury within 2 days, and they need a service agreement with the board, applied for with the Health Care Provider Application. The doctor's first report asks you to attach the functional abilities form and give the worker a copy. All the forms are English PDFs, and the doctor's first report, the functional abilities form and the physiotherapy reports are fillable. Vero Documents fills them from the visit note and the chart, and you review and sign.

Physicians and nurse practitioners

F-0044

Functional abilities form

Sets out a worker's functional abilities and restrictions so the employer can accommodate an early, safe return to work.

Completed by
Health care provider (physician or other treating provider)
Format
Fillable PDF
Language
English
Official pagePDFForm details

Physiotherapy

Chiropractic

Psychology and mental health

Massage therapy

Dental

Hearing

More Canadian forms

Workers' compensationEvery province and territory255 formsYukon, Northwest Territories and NunavutYukon, Northwest Territories and Nunavut39 forms

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

How soon must I report to the Yukon WSCB?

Within 2 days of treating a work-related injury. Physicians use the Doctor's first report (F-0043) and can fax or mail it using the details printed on the form. You also need a service agreement with the board, which you apply for with the Health Care Provider Application.

Is the Yukon functional abilities form an off-work note?

No, and the form says so itself. The Functional abilities form (F-0044) sets out the worker's abilities and restrictions, such as lifting, reaching, stairs, driving and screen time. It also gives the estimated duration of the limits, so the employer can accommodate an early and safe return to work. Attach it to the Doctor's first report and give the worker a copy.

Which forms do Yukon physiotherapists and chiropractors use?

Physiotherapists complete the Physiotherapy initial assessment report (F-0199), then the combined Physiotherapy Extension and Discharge Report (F-0203) for extension requests and discharge. Chiropractors use the first report and assessment (F-0093), a progress report (F-0149) and a discharge report (F-0150). Free-text fields on the physiotherapy initial assessment hold about 2,000 characters each.

What do psychologists send to the Yukon WSCB?

A Psychological initial assessment report (F-0077), then Psychological progress reports (F-0075). The Psychological functional abilities form (F-0071) sets out the worker's psychological and cognitive abilities and restrictions for return to work. A psychologist or another mental health provider can complete it.