BIRP Progress Note Checklist

• Session Date

  Date

• Therapist/Counselor Name

• Patient Name

• This checklist lists the questions to discuss during the patient visit. Tick the check box if the item is addressed and add notes as needed.

Behavior

• What were the client's thoughts and statements during the session?

• What did the therapist/counselor observe about the patient's mood, appearance, and other behavioral factors during the session?

Intervention

• What goals and objectives were addressed during the session?

• Was the homework from the previous session reviewed?

Response

• What is the patient’s current response to the intervention in the session?

• How far along has the patient progressed from the goals and objectives outside of the session?

Plan

• What in the Treatment Plan needs revision?

• What is the therapist/counselor going to do next?

• When is the next session?

General Checklist

• Does the note connect to the patient's individualized treatment plan?

  Yes

  No

  N/A

• Are the patient's strengths and limitations in achieving goals noted and considered?

  Yes

  No

  N/A

• Is the note dated, signed and legible?

  Yes

  No

  N/A

• Is the patient's name and/or identifier included on each page?

  Yes

  No

  N/A

• Has referral and collateral information been documented?

  Yes

  No

  N/A

• Does the note reflect changes in client status (e.g., Global Assessment of Functioning (GAF), measures of functioning)?

  Yes

  No

  N/A

• Are all abbreviations standardized and consistent?

  Yes

  No

  N/A

• Did the counselor/supervisor sign the note?

  Yes

  No

  N/A

• Would someone not familiar with this case be able to read this note and understand exactly what has occurred in treatment?

  Yes

  No

  N/A

• Are any non-routine calls, missed sessions, or professional consultations regarding this case documented?

  Yes

  No

  N/A

Sign-Off

• Name and Signature of Therapist/Counselor

  Sign