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Appendix A: Data Collection Questionnaires REPORT REVIEW TEMPLATE Section 1. Assessment Findings Evacuee Data 1. Reason For Referral (Narrative detail) () Ability to perform specified job (Job Match)
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Start by gathering all the necessary information related to the incident or injury that occurred. This includes the date, time, and location of the incident, as well as any witness statements or supporting documents.
02
Begin filling out the wsib report - appendix by providing your personal details, such as your name, address, contact information, and occupation.
03
Provide a detailed account of the incident, including what happened, how it happened, and any factors that may have contributed to the incident.
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Describe the nature of the injury or illness that resulted from the incident. Be specific and include any symptoms or diagnoses provided by medical professionals.
05
Indicate whether you sought medical treatment for your injury or illness and provide details of any healthcare professionals you visited or are currently treating with.
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Employees who have experienced a work-related injury or illness that requires them to seek medical treatment or miss time from work.
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Employers who are required by law to report any work-related incidents or injuries to the workplace safety and insurance board (wsib).
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Healthcare professionals who are treating a patient for a work-related injury or illness and need to provide documentation or assistance for the wsib claim.
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The wsib report - appendix is a supplementary document that provides additional details about a workplace injury or illness.
Employers are required to file the wsib report - appendix when there is a workplace injury or illness that meets the criteria for reporting to the WSIB.
The wsib report - appendix can be filled out online on the WSIB website or by completing a paper form and mailing it to the WSIB.
The purpose of the wsib report - appendix is to provide detailed information about a workplace injury or illness so that the WSIB can assess the claim and determine appropriate benefits.
The wsib report - appendix must include details about the injured worker, the injury or illness, the circumstances surrounding the incident, and any witnesses.
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