FORM CODE CF10-GFN

Calayan Educational Foundation, Inc. FORM NAME Group Facilitation Notes

PREPARED BY Guidance Center
GUIDANCE CENTER REVISION NO. 0
EFFECTIVE DATE October 2023
GROUP FACILITATION NOTES

PART I – STUDENTS' INFORMATION (CONTINUE TO SEPARATE SHEET IF NECESSARY)

NAME GRADE / YEAR SECTION / COURSE SEX

PART II – SESSION INFORMATION

DATE: SESSION NO.

TIME: PLATFORM:

PART III – GROUP BEHAVIOR OBSERVATION

GROUP GOAL(S) / OBJECTIVE(S) ATTENDED STRESSORS/EXTRAORDINARY EVENTS/NEW ISSUES PRESENTED
(CONTINUE TO SEPARATE SHEET IF NECESSARY)
NOTE: ( ) CHECK IF DOES NOT APPLY

GROUP BEHAVIOR RATING (CHECK OR SHADE THE BOX) GROUP EVALUATION (CHECK OR SHADE THE BOX)

HIGH MEDIUM LOW N/A HIGH MEDIUM LOW N/A

Seemed interested in the
Participation
group
Initiated positive
Discusses issues
interactions
Shared emotions Insight
Helpful to others Motivation
Emotional
Focused on group tasks
expression
Disclosed information
Stays on task
about self
Objectives being
Understood group topics
met
Participated in group
exercises
Showed listening
skills/empathy
Offered opinions/
suggestions/ feedback
Seemed to benefit from
the session
Suggestion
considerations
addressed
 FORM CODE CF10-GFN
Calayan Educational Foundation, Inc. FORM NAME Group Facilitation Notes
PREPARED BY Guidance Center
GUIDANCE CENTER REVISION NO. 0
EFFECTIVE DATE October 2023

PART IV – COUNSELOR’S NOTES

SUMMARY OF THE SESSION (CONTINUE TO SEPARATE SHEET IF NECESSARY)

IMPRESSION(S) (CONTINUE TO SEPARATE SHEET IF NECESSARY)

SUGGESTION(S)

( ) FOR INDIVIDUAL COUNSELING NAME(S)_____________________________________________________________

_____________________________________________________________
_____________________________________________________________
( ) FOR OUTSIDE REFERRAL NAME(S)_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
( ) OTHER(S) PLEASE SPECIFY______________________________________________________
_____________________________________________________________
_____________________________________________________________
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NEXT ACTIONS AND HOMEWORK

NOTE: ( ) CHECK IF DOES NOT APPLY

DATE AND TIME OF NEXT SESSION ATTENDING COUNSELOR / ASSOCIATE SUPERVISOR’S NOTE SUPERVISED BY

SIGNATURE OVER PRINTED NAME SIGNATURE OVER PRINTED NAME