OCR Session Note Please enable JavaScript in your browser to complete this form.What type of service are you providing?OCR direct service to defendantOCR Assessment or case-related AdminOCR Supervision SessionOCR broader administrative activityOCR instructor training sessionWho is providing ADMIN or SUPERVISION service?ErinJennyJoyNatalieLAS - 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 sessionMaintenance Session (regularly scheduled)Scheduled but Failed SessionDescribe type of Admin Session *INTAKE interview (doctoral level)30-day update or case closure letterSupervision or Trainingfinal full assessmentMonthly report to the stateWhich County's Court? *Adult Court GRANT (Butler, Warren, Clinton, Preble, Pike, Highland)Adult Court OUTSIDE Grant (outside of B,W, Cl, H, Pi, Pr)Juvenile Court Case - fee for serviceOTHERThis 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?Adams JVButler JVClinton JVHighland JVPike JVPreble JVRichland JVWarren JVOTHER JVWhich Instructor, Admin, or student tracking training? *Kami H.Natalie M.Tyler R.Sheila T.Erin N.Jenny OJoy McTraining - I'll add my name at the endYou should choose your name here.SERVICE DATE *IF the session didn't last more than 5 minutes, check hereSession DID NOT last more than 5 minutesIS THIS A CORRECTED/Duplicate Note?YESNo, it's the original entryLength of session (in minutes) if longer than 5 minutes. *In no less than 15-minute increments (please) 90, 60 (minutes) 45, 30, 0 (no show, but alerted us ahead of time)Did the instructor travel more than 20 minutes each way for the session?Yes, bill for travelNo, minimal travel was requiredHere we are documenting travel for billing. Why didn't session occur?Cancelled Ahead of TimeNO SHOW - no notice - or really lateTerminated Session early-on*Instructor had to rescheduleTracking Billing and Attendance information here - so this is if there was NO appreciable session (less than 5 minutes)Was there a professional INTERPRETER?There was a professional INTERPRETER involvedNo.Effort in session *ExcellentGoodFairPoorN/AHow 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.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 adequatelypsychiatric medication, treatment complianceabstinence from intoxicantsdecrease in self-care, hygiene, sleepattending work, meetings, other structured obligations or eventschanges in mood regulation, cognitions, affect (speech, affect, bizarre behavior or thoughts)OTHER: see PROGRESS NOTEProgress toward restoration *N/A - noneMaintenanceExcellentGoodFairPoorMaintenance Session - Continues to Maintain/ImproveSerious DeteriorationWhat 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.Progress/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).Training - Your NameType your name in the box so we can show you participated in the training.Submit for billing
