WCB 123 Form

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Tell Your Employer


details of your injury
After receiving notice, your employer must report your injury to WCB within 72 hours if:

If you are injured at work


Tell Your Health Care Provider

Tell WCB

you were injured at work


Your doctor or Chiropractor must report your injury to WCB within 48 hours.

Send your Report of Injury form to WCB right away!


You can get forms from your employer, any WCB oce or report online at www.wcb.ab.ca.

you need medical treatment beyond rst aid, or you cannot do your job beyond the day of accident.

Avoid delays. Report early!


Send forms: By mail: PO Box 2415, Edmonton, AB T5J 2S5 By fax: Edmonton 780-427-5863 or Toll-Free 1-800-661-1993 For more information call: Edmonton: 780-498-3999 or Toll-Free 1-866-922-9221
Website: www.wcb.ab.ca

G-083 REV MAY 2008

Note: Employers are required under the Workers' Compensation Act, Section 145, to hang this poster in a place where employees can see it.

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