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​Report templates

Here you'll find the report templates that you will need as a health care provider to note your key findings and recommended care plan.

Chiropractors, counsellors, kinesiologists, occupational therapists, physiotherapists and psychologists can submit reports to ICBC through the Health Care Provider Invoicing and Reporting (HCPIR) application. Visit our Support and resources page for instructions on submitting invoices through HCPIR.

For more information, visit the invoicing and reporting page.

Important: obtaining patient consent

It is important to discuss with your patient the purpose of the reports and ensure that you have received their consent to share the report with ICBC, consistent with your information sharing guidelines. Please ensure reports and information are shared with ICBC only where patient consent has been granted.

Where patient consent has not been granted to share reports with ICBC, ICBC will send the Health Care Provider Report request letter (CL491) to the health care provider outlining applicable legislation that permits ICBC to obtain the report.

ICBC is not permitted to request any other reports, diagnostic test results, or clinical records without patient consent.

Acupuncturists and registered massage therapists may also be requested to submit clinical records.

Report templates

Please use the applicable report template. To fill in and save a PDF, download and open in Adobe Reader (version 8 or higher). Ensure Adobe Reader plugin is installed on your computer.

How to fill out standard medical reports



General Practitioners


Nurse Practitioners

Occupational therapists