• Re-Entry Progress Note

  • Next Section For Counselor Use

  • Date

    ___________________________________________

  • Topic

    ___________________________________________________________________

    ___________________________________________________________________

  • Time In

    ___________________________________________

  • Time Out

    ___________________________________________

  • Goals

  • 1. Employment*

  • Progress and Participations ______________________________________________

    ____________________________________________________________________________

  • 2. Family Relationship*

  • Progress and Participations ______________________________________________

    ____________________________________________________________________________

  • 3. Community Resources*

  • Progress and Participations ______________________________________________

    ____________________________________________________________________________

  • 4. Self-Help Groups*

  • Progress and Participations ______________________________________________

    ____________________________________________________________________________

  • 5. Personal Goals*

  • Progress and Participations ______________________________________________

    ____________________________________________________________________________

  • 6. Relapse Prevention*

  • Progress and Participations ______________________________________________

    ____________________________________________________________________________

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year

  • Counselor observation of client participation in group (circle one):

    Attentive         Involved         Defensive         Withdrawn

     

    Counselor Signature _____________________________________

    Date ______________________________________

  • Should be Empty: