COUNSELING PROGRESS REPORT for United States Probation Office United ...
Local Form 35 (WD/KY, 09/93)
Type of Counseling: Treatment Facility:
Client:
COUNSELING PROGRESS REPORT for
United States Probation Office United States District Court Western District of Kentucky
Report Period:
__________________________________
Please indicate appropriate response:
1. Attendance:
Always present Has missed (number) sessions Never present
2. Attitude:
Excellent Above average Neutral Below average Poor
3. Participation/ Cooperation: Excellent Above average Neutral Below average Poor
4. Progress:
Excellent Good
Fair
No change Regressing
5. Medication:
None prescribed
Listed below
6. Diagnosis:
7. Comments:
Counselor: Date:
................
................
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