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It is designed for claimants to document and request reimbursement for childcare services related to their recovery or claim process. The form requires essential worker details, including claim number, contact information, and accident history. 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Yes  No\u003Cbr>Please complete the name and address section below with who provided the service. |  |  |  |\n| --- | --- | --- | --- |\n| Name and address of who provided service\u003Cbr>(please print) | Provider’s Signature |  | Date (YYYY/MM/DD) |\n|  | Provider’s Name (please print) |  |  |\n|  | FEE CODE EX18 | Telephone Number |  |\n|  |  | Email Address |  |","cbCairssEws9E7qK","https://ap.wps.com/l/cbCairssEws9E7qK","pdf",190287,"English","# Worker Details\n# Service Itemization\n## Calculation of Costs\n# Service Provider Information\n## Provider Signature and Contact Details","[{\"question\":\"What information is required for the worker details section?\",\"answer\":\"The worker must provide their surname, first name, initial, date of birth, complete address, email address, WCB claim number, and the date of the accident.\"},{\"question\":\"How should the childcare service be itemized on this invoice?\",\"answer\":\"The service provider must record the date of service, a description of the service provided, the hourly rate, the number of hours billed, and the calculated total cost for each entry.\"},{\"question\":\"Who is responsible for signing the invoice?\",\"answer\":\"The service provider must sign the document in the provided signature field to authenticate the billing, alongside their printed name, telephone number, and email address.\"}]","Childcare Invoice - WCB Alberta | PDF",1790011973]