Discussion- 200-250 words
HN330: Client Contact Form
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Course: HN330
Client Contact (This is a brief summary of the client meeting approximately 1 page total)
Client Name:
Date:
Location:
Start Time:
Stop Time:
Type of Contact (Home, Community, Office, or Telephone):
Others, in addition to client, present and their relationship to client:
Client’s report of present situation and changes since last meeting:
Progress toward goals:
Barriers to achieving goals (if new barrier, update ISP):
Goal(s) focused on in this meeting and what was accomplished:
Client plan for next steps and case manager role between now and next meeting:
Brief evaluation of client status as of this meeting; note any concerns or potential risk areas with plan. How does client report they are doing overall?
Next Meeting:
Date:
Time:
Location:
________________________________________
Case Manager Signature:
Date: