Forensic Psych Assistant Notes Please enable JavaScript in your browser to complete this form.Is this a NEW Note? *YES - newNo - it's a CORRECTION to the old noteWhat type of service are you providing? *criminal case direct interview, collateral, case specific timecriminal case training/supervision sessionWho is the provider? *CaraColleenBeckyWho is your supervisor/legal examiner? *ErinJennyLAS - FIR of the defendant being evaluated *Type "training" or "program" for a training activity.SERVICE DATE *This is the date you did the work - only one day per note.What type of services did you provide (WAS SCHEDULED) on this date?Clinical InterviewCollateral ContactTesting ScoredReport writingYou can choose one or up to 4. Just as long as they are all on the same day.IF the scheduled session didn't last more than 5 minutes, check hereSession DID NOT last more than 5 minutesWe will pay you for 30 MINUTES if a scheduled session does not occur because the defendant fails to show up and we don't have time to contact you.Why didn't session occur?Cancelled Ahead of TimeNO SHOW - no notice - or really lateTerminated Session early-on*FESC had to rescheduleTracking Billing and Attendance information here - so this is if there was NO appreciable session (less than 5 minutes)Length of evaluation/interview (in minutes) *In no less than 15-minute increments (please) 90, 60 (minutes) 45, 30, 0 (no show, but alerted us ahead of time)Did you travel more than 20 minutes each way for the session?Yes, bill for travelNo, minimal travel was requiredHere we are documenting travel for billing. 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 - My Supervisor was made aware. 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 Note (see instructions) - session completeCollateral, testing results, and report writing should go in a document (not in a progress note). But if there is something to document - (like why they didn't show up) do that briefly here. Otherwise, upload it, or email it to your supervisor.ADD a file (word doc, pdf, or spreadsheet) here Click or drag files to this area to upload. You can upload up to 3 files. You can add a file (like the collateral information) if you want to. Submit to billing and supervision
