Diego Fernandez — Feb 5, 2025
ApprovedCN-20265 · Client Visit · Dana Reyes
Client
Task Type
Client Visit
Date of Service
Feb 5, 2025
Start / End
— – —
Total Units
6
Service Code
H0043
Program
Housing - TAP
Stage
—
Place / Contact
Home · In-person
Billable
Yes
Staff:Dana ReyesWLP: VerifiedMedicaid: Verified Billing: Approved
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Client Name*
Diego Fernandez
Date*
2025-02-05
Duration
Not set
Start Time*
Not set
End Time*
Not set
Place of Service*
Home
Provider (Case Manager)*
Dana Reyes
Task Type*
Client Visit
Contact Type*
In-person
Program*
Housing - TAP
Stage
—
Service Scope*
Direct Client Service
Goals (Active Treatment Goals)*
No active treatment goals available for this client.
Presenting Concerns / Client Report
Chief Complaint*
Client's Self-Report*
Current Symptoms*
Significant Events Since Last Session
Safety Concerns (if applicable)
Appearance & Demeanor
Appearance
Hygiene / Grooming
Dress
Eye Contact
Behavior / Psychomotor Activity
Mood
Affect
Speech
Thought Process
Thought Content
Orientation
Insight / Judgment
Other Observations
Medical Necessity
Current Symptoms*
Functional Impairments*
Impact on Daily Functioning*
Reason Treatment Remains Medically Necessary*
Interventions Provided — OutcomesSelect all that apply and document supporting evidence.
Clinical Impressions*
Progress Toward Treatment Goals*
Response to Interventions*
Changes in Symptoms or Functioning*
Risk Assessment (if applicable)
Document AttachmentsNo documents attached
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