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To Physician
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From Counselor
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Patient REPORTED USE OF ILLEGAL SUBSTANCE/S OR POSITIVE DRUG TEST
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Patient self-reported NEW substance related legal charges or convictions
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Patient self-reported SOBRIETY since last monthly report
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Patient KEPT all appointments for case management
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Patient KEPT all appointments with PHYSICIAN
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Patient KEPT all appointments for individual and group therapy
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Patient ACTIVELY participated in individual counseling
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Patient ACTIVELY participated in group therapy
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Patient MISSED individual counseling, called & provided acceptable reasons
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Patient CHANGED appointment 24 hrs in advance & kept NEW appt same week
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Patient INVOLVED family in treatment program
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Patient In:
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Patient MAKING PROGRESS ON OVERALL TREATMENT GOALS
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Patient MAKING PROGRESS ON MENTAL HEALTH GOALS
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Patient MAKING PROGRESS ON SUBSTANCE ABUSE GOALS
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PATIENT MAKING PROGRESS BY KEEPING SELF SAFE
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Comments/Recommendations
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