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PID -02254999- WU2754420
Complex Care Counselling
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PID -02254999- WU2754420
PID -02254999- WU2754420
Patient ID Number
Allocated Psychotherapist
Date
PHQ9 Score
GAD-7 Score
Risk Assessment
Has the Client Self-Harmed Since The Last Session?
*
No
Yes
Has the Client Currently Got Thoughts of Self-Harming?
*
No
Few Days
Most Days
Almost Every Day
Does the Client Think About Ending His/Her Life?
*
No
Few Days
Most Days
Almost Every Day
Does the Client Know How To End His/Her Life?
*
No
Yes
Does the Client Think That Life is Not Worth Living?
*
No
Few Days
Most Days
Almost Every Day
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Session Notes
This Session Notes
*
Key Areas To Address In The Next Session
*
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Session Number Allocated
Current Session Number?
*
Remaining Sessions
*
Is The Treatment Plan on Course For Completion within The Sessions Allocated?
*
Yes
No
If No, How Many Additional Sessions is Forecasted?
Explain Rational of Request for Additional Sessions
Confirmation
Date of Next Session
*
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Submit
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