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Get Canada C019 2017
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How to fill out the Canada C019 online
This guide provides clear instructions for completing the Canada C019 form, specifically designed for invoicing physical therapy services. Follow the steps outlined below to ensure accurate and efficient submission of your form online.
Follow the steps to complete the Canada C019 form online.
- Press the ‘Get Form’ button to access the Canada C019 form and open it in your selected editing tool.
- Begin filling out the top section of the form by entering the WCB claim number, worker’s surname, first name, and address details including street, city, province, postal code, and telephone number.
- Provide the personal health number and fill in the date of the accident in the format yyyy/mm/dd, along with the worker’s initial and date of birth in the same format.
- In the service items section, input the date of service for each item, the corresponding health service code, a short description of the service, the quantity provided, the rate per unit, and the total amount billed.
- If you have any sundry items, repeat the process in the designated sundry items section, ensuring you include the date of service, health service code, quantity, description, fee submitted, and total amount billed.
- In the payment section, specify the name and address to whom the fee is payable and provide the provider’s name, WCB billing number, telephone number, fax number, and provider reference number.
- Finally, enter the date of completion in the format yyyy/mm/dd, review all the information provided for accuracy, and ensure it is printed clearly. After completing the form, you can save changes, download, print, or share the completed document as needed.
Get started with filling out your Canada C019 form online today!
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