How documentation works
The shared lifecycle behind every clinical document — drafting, autosave, signing, submitting for approval, and where to find work that needs attention.
Writing a progress note
Record a service contact — who was present, what happened, the time spent, and the goals you worked on — then submit it for approval.
Visitation notes
Document a supervised parenting time visit — transportation, the visit itself, your observations, and recommendations — and submit it for approval.
Group notes
Document a group session you facilitated — pick the service, record the shared narrative once, and add the clients from your caseload who attended.
Treatment plans & goals
Build the plan that drives a family's work — presenting problems, goals and objectives — including the common-goals library and 90-day reviews.
Safety plans
Create a forward-looking safety plan with a family — choose the plan type, fill in the required sections, and capture the family's signature.
Biopsychosocial (BPS)
Complete the long-form clinical assessment that captures a client's full history, becomes the foundation for their treatment plan, and can be linked across a family's cases so you never redo it.
Standardized assessments
Administer validated screeners (PHQ-9, GAD-7, ACE, DAST-10, MDQ, C-SSRS) — how scoring works, the edit window, and the privacy rules around responses.
Crisis incident reports
Document a safety-related crisis — severity, what happened, who was notified, and the approval (and countersignature) it requires.
Concrete assistance
Record financial or material support provided to a Family Preservation family, with the required receipt attached.
Monthly reports
The monthly report DCS requires for each active case — how it's built from your approved notes, the goal sections you complete, and how it gets to DCS.
Discharge summaries
Write the document that closes a case — services provided, the family's involvement, aftercare, and each goal's final outcome.