Canada WSIB 0153A 2007-2025 free printable template

Print Mail To 200 Front Street West Toronto ON M5V 3J1 OR Fax To 416-344-4684 1-888-313-7373 reset save Physiotherapist s Treatment Extension Request Claim Number Please PRINT in black ink. Patient Information Last Name First Name Address City Telephone Date of Birth dd/mmm/yyyy Date of worker s first treatment Initials Prov* Postal Code Sex M F Date of assessment on which this report is based Message to Physiotherapist To ensure continuity of treatment this document must be completed in...

How to fill out ca wsib extension form

How to fill out Canada WSIB 0153A

1. Obtain the WSIB 0153A form from the WSIB website or your employer.
2. Fill out the personal information section, including your name, address, and contact details.
3. Provide information about your employer, including their name and WSIB number.
4. Describe the incident that led to the claim, including the date, time, and location.
5. Detail any injuries sustained, including medical attention received.
6. Indicate the type of compensation you are claiming.
7. Review the form to ensure all information is accurate and complete.
8. Sign and date the form.
9. Submit the form to the WSIB either by mail or electronically.

Who needs Canada WSIB 0153A?

1. Employees who have been injured at work or have developed an occupational disease.
2. Self-employed individuals who wish to register their work-related injury with WSIB.
3. Employers who need to report incidents involving their employees to WSIB.

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What is Canada WSIB 0153A?

Canada WSIB 0153A is a form used for reporting workplace insurance information, specifically related to workplace injuries and illnesses in Ontario, Canada.

Who is required to file Canada WSIB 0153A?

Employers in Ontario who have registered with the Workplace Safety and Insurance Board (WSIB) and are required to report workplace injuries or illnesses must file Canada WSIB 0153A.

How to fill out Canada WSIB 0153A?

To fill out Canada WSIB 0153A, employers need to provide details such as the nature of the injury, the employee's information, the incident details, and any witnesses present. It is important to follow the guidelines provided by WSIB when completing the form.

What is the purpose of Canada WSIB 0153A?

The purpose of Canada WSIB 0153A is to document and report workplace injuries and illnesses to the WSIB, ensuring that employees receive the necessary benefits and support, and that employers fulfill their legal obligations.

What information must be reported on Canada WSIB 0153A?

The information that must be reported on Canada WSIB 0153A includes the employee's name, claim number, details of the injury or illness, date and time of the incident, nature of the incident, and any other relevant information requested by the WSIB.