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Occupational Medicine Specialist Form

CNESST Rapport d’Évaluation Médicale (Form 2064)

A downloadable Occupational Medicine Specialist form for healthcare professionals.
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Specialty

Occupational Medicine Specialist

Downloads

3 times

Type

Form

Last edited

23/07/2026

Created by

Heidi Team

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About this form

Designed for healthcare professionals managing workplace injuries under Quebec’s Commission des normes, de l’équité, de la santé et de la sécurité du travail (CNESST), this report supports the comprehensive medical assessment of permanent impairments and functional limitations following a work-related injury or occupational disease. It captures the worker’s diagnosis, current symptoms, relevant medical history, therapeutic interventions, physical or mental examination findings, diagnostic investigations, functional limitations, recommendations for further specialist assessment, and conclusions. The report also documents permanent sequelae and impairment ratings to assist the CNESST in determining permanent disability and work capacity. Heidi helps clinicians efficiently generate structured medical evaluation reports that support accurate occupational health assessments, claims management, and return-to-work planning.

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1

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Click "Auto-fill Form with Heidi" to open the form in Heidi and complete the fields straight from your note, no copying and pasting.

2

Review and edit

Check the pre-filled details and make any changes before finalising the form.

3

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Download the completed form or save it directly into your patient records and workflows.

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Spécialités

  • Médecine générale

  • Médecine spécialisée

  • Paramédical

  • Psychologie et psychiatrie

Conformité

  • Sécurité

  • Centre de confiance

Produit

  • Tarifs

  • Centre d’aide

  • État du système

À propos

  • Nous contacter

  • Témoignages client

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Ressources

  • Centre de ressources

  • Modèles créés par la communauté

Informations légales

  • Politique de confidentialité

  • Conditions d’utilisation

  • Politique d’utilisation

  • Accessibilité

  • Mentions légales