Title Page

  • Session Date

  • Therapist/Counselor Name

  • Patient Name



  • Describe the observable behaviors displayed by the patient during the session.


  • Outline the interventions or techniques used by the therapist during the session.


  • Describe in detail the patient's response to the interventions and their overall engagement in the session.


  • Highlight the plan for future sessions or recommended actions to be taken.

  • Will there be a next session?

  • Please specify the date.


  • Name and Signature of Therapist/Counselor

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.