Master Treatment Plan - LMHA
ELEMENTS TO BE INCLUDED IN
Local Mental Health Authority Master Treatment Plan
Start Date: End Date:
Clinical Formulation Summary:
|Primary Diagnoses: | |Prioritized Problem List |
|Axis I | | |1 | |
|Axis II | | |2 | |
|Axis III | | |3 | |
|Axis IV | | |4 | |
|Axis V | | |5 | |
|# |Overall Goals |# |90-Day Objectives |Services to Address Goals and Objectives |
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Signed:
Name & Credentials:
Date of Signature:
................
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