WSIB Forms

If you have suffered a work-related injury and plan on filing a claim for your treatment at our clinic with WSIB, please print and complete the following additional WSIB forms to bring with you to your appointment:

WSIB Case History & Financial Policy

WSIB Release of Information Consent Form

Numeric Pain Rating Scale

For the following specific injuries, please fill out the appropriate questionnaire as well:

Low Back Injury Pain Questionnaire (RDQ)

Shoulder Injury Questionnaire (DASH)