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302 E Manchester Blvd #203
Inglewood, CA, 90301
424-241-0164
Inglewood, CA
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Home
Services
The Team
The Space
Client Sign Up
Media
Staff Portal
Discharge Summary
Please complete the form below after a client formally discharges.
Name of Therapist
*
First Name
Last Name
Date of Admission of Client
*
MM
DD
YYYY
Initials of Client
*
Date of Discharge/Last Session
*
MM
DD
YYYY
Initial Assessment
*
Course in Treatment
*
Frequency & Duration
Therapist's Narrative & Clinical Summary
*
Note changes observed, level of participation/commitment
Discharge Status & Instructions
*
Thank you!
