The eForm6 application will guide you through the process of submitting an injury or illness report. After you submit the report, you will receive a four-digit confirmation number. There is no need to fax or mail another copy of this report after you submit online.
If you are under 16 years old, your parent or guardian must sign a PDF version of the form and upload online.
Please note: your employer needs to be aware of your injury or illness. If you have not already reported the details of this claim to your employer, please do so as soon as possible.
Before you start, have the following information ready:
- The valid eight-digit claim number for this injury or disease (if you have a number - if not, please leave claim number field blank)
- Your information ( i.e. name, date of birth, address)
- Employer information ( i.e. name, address)
- Injury or illness details ( i.e. date of injury or illness, area of injury)
- Health care information ( i.e. treatment date and location)
- Employment information ( i.e. work schedule, earnings)
- Return-to-work information (i.e. modified work details)
For all questions about online services, including support issues, please contact 1-800-387-0750 or 416-344-41000 (TTY: 1-800-387-0050) between the hours of 7:30 a.m. to 5 p.m., Monday to Friday.
Find out how to report exposure incidents.
If you have supporting documents or are having technical difficulties, please fill out a PDF version of the form and upload.
You need Adobe Acrobat Reader to view and print the completed report.