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Counseling
Chronic Illness
Couples & Affair Recovery
First Responder Counseling
Meditation
Scheduling/Forms
No Surprises Act
Contact
Every Fitt
Home
About
About Counseling & Kim
Counseling
Chronic Illness
Couples Counseling & Affair Recovery
First Responder Counseling
Meditation
TBI/PCS Yoga
Scheduling/Forms
No Surprises Act/Telehealth Rules
Counseling
Chronic Illness
Couples & Affair Recovery
First Responder Counseling
Meditation
Scheduling/Forms
No Surprises Act
Contact
Progress Note
Session Date
MM
DD
YYYY
Type of Session
Name
First Name
Last Name
DOB
MM
DD
YYYY
Case Number
Diagnosis
Client's report of progress towards goals since last session:
New issues presented:
Mental Status
Appearance
Appropriate
Unkempt
Disheveled
Eye Contact
Appropriate
Avoidant
Wandering
Intense
Demeanor
Calm/Cooperative
Hostile/Aggressive
Withdrawn
Preoccupied
Avoidant
Other
Other
Speech
Appropriate
Rapid
Pressured
Other
Other
Activity
Appropriate
Agitated
Slowed
Affect
Normal Range
Labile
Tearful
Blunted
Flat
Other
Other
Mood
Normal Range
Irritable
Anxious
Depressed
Elevated
Other
Other
Thought Process
Logical
Incoherent
Flight of Ideas
Disorganized
Racing
Other
Other
Insight/Judgement
Good
Fair
Poor
Delussions
None
Grandiose
Persecutory
Somatic
Religious
Other
Other
Hallucinations
None
Auditory
Visual
Other
Other
Obsessions/Phobias
Suicidal Ideation
None
Passive
Active
IF ACTIVE
Plan
N/A
Yes
No
Intent
N/A
Yes
No
Means
N/A
Yes
No
Homicidal Ideation
None
Passive
Active
IF ACTIVE
Plan
N/A
Yes
No
Intent
N/A
Yes
No
Means
N/A
Yes
No
Safety Plan
Additional Notes
Signature & Date
*
Thank you!