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“Championing Mental Health, Celebrating Neurodiverse Lives, and Building Stronger Communities – Together”.

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Gathering Trust Stats

*First name

*Last name

*Email - staff email

*H&C Number

*Date of first contact

*Did the client accept offer of counselling?

session 1

session 2

session 3

session 4

Session 5

Sesssion 6

Sessions attended this month

Sessions cancelled this month

*Sessions DNA'd this month

If any additional sessions have been authorised from trust

Core 10 score - start

Core 10 - finish

*Has the carer been signposted to another orgamisation / service / agency / anyone external please record all below

Date Client Fnished

Client issued with evaluation at end of counselling

Date and time is TBDLocation is TBD

028 9620 8284

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