Get Canada Wsib 3238a 2014-2025

The Canada WSIB 3238A form is an important document used to report and assess low back injuries for patients. This guide provides step-by-step instructions on how to fill out the form online, ensuring that all necessary information is accurately provided for a smooth assessment process.

Follow the steps to complete the Canada WSIB 3238A form online.

1. Click the ‘Get Form’ button to access the Canada WSIB 3238A form and open it in your online editor.
2. Begin by entering the patient and employer information in section A. This includes the patient’s last name, first name, initial, address, date of birth, and claim number.
3. Fill in the employer's name, telephone number, and address. Ensure all provided details are accurate.
4. Indicate the patient's current job title and employment status, specifying if they are working full time, part time, or not working.
5. In section B, provide details about the health professional, including their name, facility name, WSIB provider ID, and contact information.
6. Moving to section C, document the clinical information by indicating the first treatment provider and details of the patient's injury history and current symptoms.
7. Record the patient's diagnosis, summary of physical findings, and any complicating factors that may affect recovery.
8. Administer the Numeric Pain Rating Score and include the patient's range of pain, scoring accurately as per the guidelines.
9. Record the results from the Roland-Morris Disability Questionnaire and describe any limitations in the patient's daily activities.
10. In section D, outline the treatment plan and whether a referral to other health professionals is recommended.
11. Confirm if the patient can remain or return to work, specifying any regular or modified duties if applicable.
12. Finally, have the health professional sign and date the form to verify the provided information before submission.

Complete your Canada WSIB 3238A form online today for a prompt assessment.