Massage therapist's request for authorization to provide primary-level treatment.
- Completed by
- Massage therapist
- Issued by
- WCB Saskatchewan
- Format
- Language
- English
Other accredited treating practitioners close a WCB Saskatchewan file with this one-page discharge summary. It gives the dates of the final examination and treatment, the diagnosis, the worker's functional status at discharge in relation to work duties, the total appointments attended and any absences. A six-level outcome code records whether the worker was discharged with or without restrictions and whether they returned to work.
The treating practitioner completes and signs the whole summary with the clinic number and care provider number, and can note who receives a copy.
Download the current version from the source each time; forms change without notice.
Practitioner's Discharge Summary (TXD)
If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms change without notice, so download the current version from the official page before you fill it in.
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Code 1: discharged without restrictions, returned to work. Code 2: discharged without restrictions, did not return to work. Code 3: returned to work on a graduated program. Code 4: discharged with restrictions, returned to work. Code 5: discharged with restrictions, did not return to work. Code 6: did not complete the program, with the reason stated.
WCB Saskatchewan's online submission form is offered for the TXI and TXP, while the TXD is a downloadable PDF. Sign it before mailing or faxing, and put the worker's name and claim or firm number on any correspondence, as the form asks. Dates are entered month first (MM/DD/YYYY).
Use outcome code 6, 'did not complete program', and state the reason the program was not completed. Item 6 records the total appointments attended with their dates and item 7 the dates absent, which together show attendance up to the final treatment date given in item 2.