WCB Alberta prosthetics and orthotics forms and guides

Prosthetics and Orthotics specialists provide physician prescribed prosthetic and orthotic devices to injured workers in order to gain optimal function, return to work and increase daily living activities.

Worker Notice PDF 9KB
Worker Satisfaction Survey HC 426 PDF 31KB
Prosthetic and Orthotic Authorized Providers PDF 47KB
Prosthetic and Orthotic Provider Update PDF 89KB
Prosthetic and Orthotic Fee Guide XLS 332KB
Prosthetic and Orthotic Fee Guide Addition/Deletion Form HC-302 PDF 63KB
Prosthetic and Orthotic Services Invoice C537 DOC Fillable 147KB
Prosthetic and Orthotic Services Invoice C537 PDF 43KB
Prosthetic and Orthotic Services Authorization Request C998 DOC Fillable 99KB
Prosthetic and Orthotic Services Authorization Request C998 PDF 21KB
Prosthetic and Orthotic Services Status C999 DOC Fillable 97KB
Prosthetic and Orthotic Services Status C999 PDF 31KB
Microprocessor Knee Prosthetist Assessment C989 DOC Fillable 90KB
Microprocessor Knee Prosthetist Assessment C989 PDF 29KB
Microprocessor Knee Assessment Prosthetic Fact Sheet HC-425 PDF 48KB
Microprocessor Knee Prosthetist Fitting Summary C991 DOC Fillable 91KB
Microprocessor Knee Prosthetist Fitting Summary C991 PDF 30KB

Excerpt from WCB Alberta

Also see
Health care provider fact sheets in WCB Alberta
Quick online services for workers in WCB Alberta
Work related joint disorders