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WorkSafeNB SUCCEED Discharge Report

SUCCEED is WorkSafeNB's six-week, six-session early intervention program giving workers with a traumatic psychological injury immediate access to care, without waiting for the claim to be accepted. At the end, the provider sends this three-page report covering treatment dates and delivery, engagement, components delivered, pre-treatment and discharge scores, functioning, suicide risk, barriers and recommendations.

Who completes it

The SUCCEED provider completes it; WorkSafeNB says the program is delivered by WorkSafeNB-approved licensed social workers and counselling therapists. A signature is not required when submitting through MyServices.

Submitting and payment

How to submit it
Submit it through MyServices, by toll-free fax or by mail; if you fax a form, don't mail it as well.
Who pays
SUCCEED is a WorkSafeNB program delivered by WorkSafeNB-approved providers, and access to it is not conditional on the claim being accepted.

Good to know

  • Treatment components to tick are psychoeducation, safety and stabilization, reprocessing of trauma using three-part narrative construction, and discharge planning.
  • Report GAD-7, PHQ-9 and PCL-5 symptom severity and functional health scores at pre-treatment and discharge, each marked improved, no change or worse.
  • If suicide risk is medium or high, contact the case manager and refer the worker as appropriate, and outline a safety plan on the form.
  • Recommendations range from return to full duties or graded return with occupational therapy to substance use services, psychiatric or medical review, or further trauma-focused treatment.

Get the official form

Download the current version from the source each time; forms change without notice.

SUCCEED Discharge Report

Résumé de dossier RÉUSSIR

Official pagePDFVersion française

Fill it with Vero

Upload the fillable PDF 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.

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How this list is checked

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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Frequently asked questions

What is WorkSafeNB's SUCCEED program?

An early intervention program for workplace trauma that gives workers with a traumatic psychological injury immediate access to psychological care when they apply for compensation. It lasts six weeks, or six sessions, is not conditional on the claim being accepted, and has eligibility requirements.

Who can provide SUCCEED treatment?

WorkSafeNB says the program is delivered by WorkSafeNB-approved licensed social workers and counselling therapists. The discharge report asks for the provider's WorkSafeNB provider number and preferred contact method, and sessions completed are reported out of six.

Is the SUCCEED Discharge Report available in French?

Yes. The French version, Résumé de dossier RÉUSSIR, is posted on WorkSafeNB's French-language site, and WorkSafeNB's forms list dates the English report May 25, 2022. The health care forms page lists it for psychologists, social workers and counselling therapists, next to the Mental Health Questionnaire.