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It specifies that the physician must not enclose the report with the invoice; instead, it must be given to the accident victim after a claim is filed. Sections request patient and accident details, examination and death dates, injury descriptions, pre-existing conditions, prescribed treatment, functional limitations, disability duration, and likely permanent impairment or scars, plus physician/SNP identification and disabled parking permit criteria.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/notice-to-the-physician-initial-report-accident-victim-compensation-reimbursement/307772/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/notice-to-the-physician-initial-report-accident-victim-compensation-reimbursement/307772.png","ImageObject",300,407,{"name":92,"@type":93},"8796093062539","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-21","2026-09-19",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What should the physician do when submitting an invoice to the SAAQ for reimbursement?","Question",{"text":112,"@type":113},"Do not enclose a copy of the Initial Report with the invoice. Give the Initial Report to the accident victim, who will send it to the SAAQ if applicable, along with the Claim for Compensation form.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"When should the accident victim send the report after filing a claim?",{"text":117,"@type":113},"Send the report after the claim for compensation has been filed. Use the online service or call the SAAQ during the listed business hours to file the claim.",{"name":119,"@type":110,"acceptedAnswer":120},"What information must be completed by the physician or SNP in the Initial Report?",{"text":121,"@type":113},"Provide accident and examination (and death, if applicable) dates, describe injuries/diagnoses and any pre-existing conditions, indicate whether treatment was prescribed and its type, specify functional limitations, estimate the disability period, and indicate whether permanent impairment or scars are likely.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},307772,1789854788,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":66,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":133,"file_id":134,"file_url":135,"file_type":136,"file_size":137,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":138,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":139,"faqs":140,"seo_title":141,"seo_description":67,"update_tm":129,"read_time":39},8796093062539,"NOTICE TO THE PHYSICIAN  \nIMPORTANT! When you send your invoice to the Société de l’assurance automobile du Québec (SAAQ) for reimbursement, please  DO NOT ENCLOSE a corresponding copy of the Initial Report.  \nPlease give the report to the accident victim, who will send it to the SAAQ, if applicable, along with the Claim for Compensation form .  \nInitial Report  \n􀁮 Note to the physician: IMPORTANT! When sending your invoice to the Société de l’assurance automobile du Québec (SAAQ) for reimbursement, DO NOT ENCLOSE this document. Instead, you must give this document to the accident victim so that he or she may send it to the SAAQ.  \n􀁯 Note to the accident victim: Send us this report after your claim for compensation has been filed. To file a claim for compensation, use our online service at [saaq.gouv.qc.ca](saaq.gouv.qc.ca) or call us at 1-800-361-7620 from Monday to Friday, between 8:30 a. m. and 4:30 p. m.  \n􀁰 Fees related to this report are either paid directly to the physician or reimbursed to the accident victim, if the accident victim paid them, up to the maximum allowable amounts determined by the SAAQ.  \n\n| Section 1 – Information on the accident victim |\n| --- |\n| Last name and first name (print) Claim number, if known\u003Cbr>|\n\n\n| Section 2 –To be completed by the physician or the specialized nurse practitioner (SNP) |\n| --- |\n| Date of the accident Date of the examination Date of death (if applicable)\u003Cbr>Year Month Day Year Month Day Year Month Day\u003Cbr>Describe the injuries or diagnoses related to the accident (specify the location of any injuries to the skin) . Describe any pre-existing medical conditions that could have an impact on the progress of the injuries. Has treatment been prescribed?  Yes  No If so, specify the type:  Medication1  Surgery  Physiotherapy  Occupational therapy\u003Cbr> Chiropractic  Acupuncture  Psychotherapy  Other, specify:  |\n| 1 Important: Written justification must be provided for any medication that is not listed in the basic prescription drug insurance plan Does the accident victim have functional limitations and/or restrictions?  Yes  No\u003Cbr>If yes, please specify:  \u003Cbr>Year Month Day\u003Cbr> Estimated disability period:  1 week or less  1 to 4 weeks  more than 4 weeks  End date, if known:   |\n| Will the accident-related injuries likely result in: Permanent impairment?  Yes  No  Cannot say\u003Cbr>Scars?  Yes  No  Cannot say |\n| Year Month Day\u003Cbr> Will you be providing the clinical follow-up for this patient?  Yes  No  If yes, indicate the date of the next appointment:    Would you like an SAAQ representative to contact you?  Yes  As needed  No  |\n\nSection 3 – Disabled parking permit  \n\n| To obtain a disabled parking permit, the individual must meet the requirements indicated on the SAAQ website at[saaq.gouv.qc.ca/personnes-mobilite-reduite/obtenir-vignette-stationnement/](saaq.gouv.qc.ca/personnes-mobilite-reduite/obtenir-vignette-stationnement/) .\u003Cbr>Does the invidual have a disability resulting in a loss of independence or risk to health and safety with respect to travelling for at least 6 months?  Yes  No If yes, what kind of permit is required?  Permanent  Temporary |  |  |  |  |  |  |\n| --- | --- | --- | --- | --- | --- | --- |\n| Information on the physician or SNP |  |  |  |  |  |  |\n| Last name and first name (print) |  |  |  | Professional licence number |  |  |\n| Address |  |  |  |  |  |  |\n| Postal code | Telephone Extension\u003Cbr>|  | Fax |  |  |  |\n|  |  |  |  |  |  | THERE ARE THREE WAYS TO SUBMIT A DOCUMENT: Through the Reimbursement of Expenses and Document Submission online service: [saaq.gouv.qc.ca/envoidocuments](saaq.gouv.qc.ca/envoidocuments)\u003Cbr>[By fax:](By fax: 1-866-289-7952)[ 1-866-289-7952](By fax: 1-866-289-7952)\u003Cbr>By mail: Société de l’assurance automobile du Québec Case postale 2500, succursale Terminus Québec (Québec) G1K 8A2\u003Cbr>Keep the original or a copy for your files. |\n| Email |  |  General practitioner\u003Cbr> Specialist, specify: |  |  SNP |  |  |\n| Signature (do not use ","cbCaii18IjKJlxWV","https://ap.wps.com/l/cbCaii18IjKJlxWV","pdf",569647,"English","# NOTICE TO THE PHYSICIAN\n## Instructions for submission and handling\n## Notes to the physician and the accident victim\n## Fees and reimbursement guidance\n# Section 1 – Information on the accident victim\n# Section 2 – To be completed by the physician or SNP\n## Accident/examination/death dates\n## Injuries, diagnoses, pre-existing conditions\n## Treatment, functional limitations, disability period\n## Follow-up clinical appointment and SAAQ contact preference\n# Section 3 – Disabled parking permit\n## Eligibility requirements and permit type\n# Information on the physician or SNP\n## Contact and professional details\n## Signature and date\n# Protection of Personal Information\n## Privacy and information sharing statements\n# RN – Société de l’assurance automobile du Québec","[{\"question\":\"What should the physician do when submitting an invoice to the SAAQ for reimbursement?\",\"answer\":\"Do not enclose a copy of the Initial Report with the invoice. Give the Initial Report to the accident victim, who will send it to the SAAQ if applicable, along with the Claim for Compensation form.\"},{\"question\":\"When should the accident victim send the report after filing a claim?\",\"answer\":\"Send the report after the claim for compensation has been filed. Use the online service or call the SAAQ during the listed business hours to file the claim.\"},{\"question\":\"What information must be completed by the physician or SNP in the Initial Report?\",\"answer\":\"Provide accident and examination (and death, if applicable) dates, describe injuries/diagnoses and any pre-existing conditions, indicate whether treatment was prescribed and its type, specify functional limitations, estimate the disability period, and indicate whether permanent impairment or scars are likely.\"}]","NOTICE TO THE PHYSICIAN - Initial Report - Accident Victim Compensation Reimbursement | PDF"]