DAILY TREATMENT AND PROGRESS NOTES

Client Name:
Gender:
Age:
Diagnosis:
Date:
Institution:

1. What treatment interventions were used?

2. Which frame of reference has been used for treatment intervention?

3. What goals have been continued, what goals have been changed and what goals have
been discontinued?

4. Have there been any changes in the time frames for reaching goals?

5. If any assistive devices are being used, how effective are these?
 6. Is there a home program, or instructions given to caregivers?

7. What activities, techniques, or modalities were used in the treatment session?

8. How did the patient respond to the treatment provided?

9. What was the level of assistance throughout the session?

Clinical supervisor signature

-------------------------------------