TERMINATION SUMMARY
Counseling Center State University of New York at Buffalo
120 Richmond Quadrangle (716) 645-2720
Buffalo, NY 14261-0019
Case # V
TERMINATION SUMMARY
Client: Date:
Number of Sessions: Duration of Therapy: to
Number of Missed Sessions:
Intake Date: Termination: Planned or Unplanned (delete one option)
Identifying Data and Presenting Problem:
Major Issues:
1.
Summary of Treatment:
(Include information related to content of sessions, client dynamics/process, progress of therapy, goal accomplishment, therapeutic relationship, and therapeutic interventions)
Status at Termination/Recommendations for Future Treatment:
__________________________ __________________________
Counselor Signature Supervisor Signature
Title Title
(if applicable)
................
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