Coaches Session Form
Coaches Session Form
Appointment Id:
What is the client session number?
Session Date
Session Time
Status of Session
Yes it happened
Cancelled
Rescheduled
No Show
Admin session
Did the session start and end on time?
Yes to both
No to both
Started on time, extended end
Started late, ended on time
How did the session happen?
In Person
Video on Gmeet
Audio on Gmeet
Whatsapp call
Phone call
Zoom
Skype
Other
Please mention the medium of the session
Does the client come with a diagnosis
Yes
No
What are their diagnoses?
Organic & Symptomatic Mental Disorders
Mental & Behavioural Disorders due to Psychoactive Substance Use
Schizophrenia, Schizotypal, & Delusional Disorders
Mood [Affective] Disorder
Neurotic, Stress-Related, & Somatoform Disorders
Behavioural Syndromes Associated with Physiological Disturbances & Physical Factors
Disorders of Adult Personality & Behaviour
Intellectual Disability
Disorders of Psychological Development
Behavioural & Emotional Disorders with Onset in Childhood and Adolescence
Unspecified Mental Disorder
Do you want to provide a provisional diagnosis?
Did the client have any medical concerns?
Yes
No
If yes, elaborate:
What primary concern did the client come with?
Occupational: Satisfaction, productivity and enrichment
Financial: Building a secure future
Social: Supportive network of people
Spiritual: Finding meaning for living
Environmental: A safe, secure & just world
Intellectual: Growth and passion for life
Physical: Sleep, nutrition & health
Emotional: Coping with adversity
Medical: Psychiatric and other Medical Issues
Neurological and Neurodevelopmental: Child, Adolescent & Adulthood
Geriatric: Age > 48, Aging and Empty Nest
Personhood: Self Identity and the Ikigai
Psychology Supervision: Students & Practitioners of Psychology
Please summarize the session:
What is your plan for the next session?
Was the client given any homework?
Yes
No
What was the homework?
What is the next session date you have recommended?
Is the client at risk of suicide
Yes
No
Unsure
Others
What was the focus of the session?
Solution
Awareness
Venting
Other
Please specify what was the focus of the session
Did you experience Transference at any moment during the session?
Yes
No
Did you experience Counter transference at any moment during the session?
Yes
No
Do you need supervision for this client / concern?
Yes
No
How did you feel about the session?
It was Terrible
It was Okay
It was Good
It was Amazing
How do you feel as a therapist after the session? :)
I have no idea how to proceed
Need to read a lot to move ahead
Can figure this out!
It's my thing- I do this well
This is easy & I can kick ass!
How do you feel as a human after the session? :)
Exhausted af
Meh, tired
I feel okayish
Going with the flow
On top of the world!