Wsib extension request 2026

1. Click ‘Get Form’ to open the wsib extension request in the editor.
2. Begin by filling in the Patient Information section. Enter the patient's last name, first name, address, city, postal code, telephone number, date of birth, and sex. Ensure all details are printed clearly in black ink.
3. In the Working Diagnosis section, provide any changes from the initial diagnosis and summarize the treatment to date. Indicate whether the worker has lost time due to the accident and if they have returned to regular or modified work.
4. Detail the Expected Outcomes with Additional Treatments by describing current symptoms and findings on examination. Include expected improvements and any factors delaying recovery.
5. Complete the Physiotherapist Information section by entering your name, clinic name, address, signature, and date. Make sure to type your name or print and sign before submission.

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