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Forensic Evaluation Service Center

FESC
ILC
OCR
Professional Education Conference Registration Form

Forensic Evaluation Service Center

Continuing Education Conflict Disclosure Form
FESC Satisfaction Survey
Forensic Psych Assistant Notes
Interventions In Lieu of Conviction
OCR Session Note
Outpatient Competency Restoration
Parenting Education Class Satisfaction Survey
Parenting Quiz 1 – Check-In
Part 2 Quiz Parenting Class
Parte 1 Examen de salida
Parte 2 Examen de salida
Professional Conference Satisfaction Survey
Professional Education Conference Registration Form
Programa de educación para padres retroalalimentación de los padres
Release of Information to FESC
Submit your report(s)
Systemic Inequities Conference – Exploring racism and trauma in forensic evaluations
Welcome to our Agency

OCR Session Note

Your Name *

Choose your name here.

What type of service are you providing?

OCR INSTRUCTION SESSION instructor-led
OCR ASSESSMENT LE led or case-related Admin
OCR Supervision Session
OCR broader administrative activity
OCR instructor training session

Who is providing ADMIN or SUPERVISION service?

Erin
Jenny
Joy
Natalie
Tyler

LAS - FIR of the Client being served *

If this is not about a specific client (you checked admin above) - type "PROGRAM" This is for when it's about program building or reporting or meeting with providers, etc.

Describe type of Session:

Regularly Scheduled education- completed session
Maintenance Session (regularly scheduled)
Scheduled but Failed Session

Describe type of Admin of Doctoral Level Session

INTAKE interview (doctoral level)
30-day update or case closure letter
Supervision or Training
final full assessment
Monthly report to the state

Which County's Court? *

This is for billing. We have a grant to pay for the Adult Courts assigned to our catchment area. Juvenile Courts are FEE for SERVICE.

If Juvenile Court, which county?

SERVICE DATE *

IF the session didn't last more than 5 minutes, check here

Session DID NOT last more than 5 minutes

IS THIS A CORRECTED/Duplicate Note?

YES
No, it's the original entry

Did the instructor travel more than 20 minutes each way for the session?

Yes, bill for travel
No, minimal travel was required

Here we are documenting travel for billing.

Why didn't session occur?

Cancelled Ahead of Time
NO SHOW - no notice - or really late
Terminated Session early-on*
Instructor had to reschedule

Tracking Billing and Attendance information here - so this is if there was NO appreciable session (less than 5 minutes)

Length of Session in 15 minute increments (rounding is fine)

Selected Value: 0

15 minute increments (up to 120)

Are there going to be CHARGES for an Interpreter?

There was a professional INTERPRETER involved
No.

Effort in session *

Excellent
Good
Fair
Poor
N/A

What areas of risk of decompensastion* are you concerned about after this session (check as many as you've identified)? *

NONE, the client is compliant and coping adequately
psychiatric medication, treatment compliance
abstinence from intoxicants
decrease in self-care, hygiene, sleep
attending work, meetings, other structured obligations or events
changes in mood regulation, cognitions, affect (speech, affect, bizarre behavior or thoughts)
OTHER, or Not a session - see PROGRESS NOTE

How concerned are you about signs of decompensation after meeting with this defendant, today?

Selected Value: 0

0 is no concern. 15 is concerned enough that you are going to contact the treatment provider. 20 means we will contact the court about this concern. 30 is concerned enough to PINK SLIP the individual. All actions must be documented in the chart.

Progress toward restoration *

N/A - none
Maintenance
Excellent
Good
Fair
Poor

Maintenance Session -

Continues to Maintain/Improve
Serious Deterioration

What slides or workbook materials did you get through?

This is so the next instructor can track where you are.

Describe defendant's mental status, if known.

Orientation, engagement, anxiety-management, emotional stability.

Instruction Progress or ADMIN Assessment/Training Note *

Describe the service you provided so you know enough about it to start the next session. Topics, progress or obstacles, interruptions, or next steps (ready to go to court, opined incomp and not restorable). IF YOU WERE IN A TRAINING SESSION, add your NAME HERE.

It is considered a fundamental right of "due process" for one to understand the mechanics of the legal proceedings so that you can participate meaningfully in your defense.

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