Session Notes

Client First Name *

Client Last Name *

Therapist Name

Supervision

No Yes

Type of Session Type of Session

Provider Credential Provider Credential

Date *

Time in

:

Time out

:

Total time of session (hours: minutes) *

Location of services rendered Location of services rendered

People present during session *

Client's response to treatment *

Did the parents/guardians participate in the session? *

Programs/ Goals parent's participated in

Checkboxes *

Client's condition upon arrival *

Address where session took place *

Address where session took place

City

State/Province

Zip/Postal

Session Narrative *

Goal Progress Please write in each goal title and the progress for that goal.

Communication goals addressed during session

Behavior Reduction goals and daily living skills addressed

Date of next session *

Therapist Name *

type your name

Therapist Signature *

Parent/Guardian Name *

Parent/Guardian Signature

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