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Workers' Compensation Board

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Ancillary Medical Report (EC-4 AMR)
Web Submission Process Tutorial

Submitting an EC-4 AMR Form For a Patient

Saving Data for Subsequent EC-4 AMR Submissions

Scroll to the bottom of the form and select the Save Data button. Save Data

Create a folder for the patient.

Sample Patient Directory

Save the file in the patient's folder, include in the name the date the form is being submitted (i.e. patientName12-31-08.xml). This file will have an .xml file extension.

Save file with patient and submit date in file name

You now have a completed form containing the patient, the employer, the doctor, the insurance carrier and billing information that you can use when you need to submit subsequent EC-4 AMR forms for that patient.

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Filling out the Form | Add Billing Information | Who Provided Services | Saving Patient Data | Adding Attachments | Submitting the Form | Successful Submissions | Saving the PDF | Printing the PDF | Submitting Additional Forms