You work for Dr. Barry Bones and your duties include completing the W.S.I.B. form 8

For this assignment complete the WSIB form filling in the blanks using the information provided.

Dr. Barry Bones

973 Plaster Way

London, ON

N5W 3K3

Tel: 519-673-9238

Fax: 519-673-9239

Invoice Number for WSIB Claim: 10000297

W.S.I.B. Provider Number: 936215732

Michael Riskope was injured earlier today at work. He is a lab technician for EZ Medical Investigations Inc., at 2493 Fullarton Road, London, ON, N2Z 9Q5. The company has 15 employees. The phone number is 519-455-9236. The doctor will fill out the Form 8 and asks you to make sure that all other pertinent information is filled in.

Michael's address is 37 Bancroft Drive, Dorchester, ON, N0C 2M0. He's married with two children. His D.O.B. is March 17, 1968. His social insurance number is 474-048-513. He can be reached at 519-268-9218. He has been working for EZ Medical since October 19, 1997 and earns $55,500 per annum.

He and a co-worker were in the lab earlier today and she dropped a specimen bottle. The contents spilled on the floor and before it could be cleaned up Mr. Riskope slipped, injuring his right wrist. He has never had this type of injury before. He notified his supervisor, Mr. Spikey Needle, of his injury and left work.

He presents to Dr. Bones' office with tenderness, bruising and swelling of his wrist. The doctor also notices that Michael's forearm and hand are tender to the touch and he is unable to flex his wrist. Dr. Bones sends him for x-rays, which are negative for fracture. The doctor's diagnosis is that Mike has a sprained wrist. He stabilizes it with a tension bandage; orders ice therapy, rest and prescribes Ibuprofen, 400 mg., q.i.d. for the pain. Dr. Bones advises Mike to take tomorrow off work, and rest the arm. He does not feel it is necessary to refer Mike to a community clinic or specialist. He expects Mr. Riskope's complete recovery to take seven to ten days.

The only restriction Dr. Bones placed on Mike's return to work was limited use of his wrist and arm until healed. A follow-up appointment is scheduled for next week.