Title Page

  • Session Date

  • Therapist/Counselor Name

  • Patient Name

BIRP Progress Note Checklist

  • 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.


  • 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?


  • What goals and objectives were addressed during the session?

  • Was the homework from the previous session reviewed?


  • 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?


  • 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?

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

  • Is the note dated, signed and legible?

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

  • Has referral and collateral information been documented?

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

  • Are all abbreviations standardized and consistent?

  • Did the counselor/supervisor sign the note?

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

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


  • 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.