School Psychology Progress Note (Student Support)

(Use professional, behaviorally specific, neutral language suitable for parent/guardian and auditor review. Attribute information by source and date. Document only what occurred today. Omit sections not relevant to this encounter.)

Date of Service: [date]

Student: [name, DOB/age, grade, school]

Encounter Type: [direct student contact / consultation / team meeting / care coordination / record review]

Setting/Modality: [in-person / phone / video; location]

Participants: [names with roles]

Provider: [name, credentials]

Consent Status: [on file / obtained today / verbal / not required] (Include only if required for this service type)

Reason for Contact

[Brief narrative summarizing stated reason for today's contact, target domain (academic, behavioral, social-emotional, attendance, crisis), urgency/safety context if relevant, and encounter goal. Include referral source if applicable.] (2–4 sentences)

Data & Observations

(Include only sources used today. Use bold labels to distinguish multiple sources. Use direct quotes sparingly for high-salience statements such as safety concerns. Note significant data gaps when they impact decisions.)

Student report: [key statements relevant to school functioning]

Clinician observations: [behaviorally specific observations of engagement, affect, regulation, thought organization as relevant]

Collateral: [teacher/parent/staff report with source and date]

Records reviewed: [attendance, grades, behavior data, prior plans, progress monitoring data as relevant]

Intervention / Actions

• [Action taken with relevant details] (List each distinct action: consultation/collaboration activities, brief intervention techniques, care coordination, crisis response. Note IEP/504/MTSS linkage when applicable.)

Risk & Safety

(Include for any direct mental/behavioral health contact or when safety concerns arise. Omit entirely for consultations/team meetings with no safety indicators.)

Concern identified: [description of risk behavior/statement and source]

Risk formulation: [indicators, protective factors, immediacy]

Actions taken: [supervision, notifications, safety plan, screening tool if used]

Disposition: [student status, parent contact, follow-up plan]

Response & Plan

Response: [student engagement, skill performance, receptivity; stakeholder response to recommendations; progress toward targets if ongoing]

Plan: (List by owner, task, and timeline)

• Student: [task] — [timeline]
• Staff: [task] — [timeline]
• Family: [task] — [timeline]
• Referrals: [service] — [offered / accepted / declined / pending]
• Follow-up: [next contact date/time or criteria for earlier contact]

Provider Signature: [electronic signature, credentials, date/time]

Supervisor Cosign: [name, credentials, date/time] (If required)