Group Attendence & Outcomes Tracking Sheet v15Nov16 MM.xlsx

	A	B	C	D	E	F	G	H	I	J	K	L	M	N	O	P	R	S
1								[Clinic Name]
2								Group Therapy Attendance and Outcomes Tracking Sheet
3	Group Name:
4	Facilitator(s):							Instructions:		#	Attended - Enter outcomes score
5	Day of Week:			Time:						Y	Attended but did not complete outcomes
6	Outcome Measure:									E	Excused absence
7	Start Date:									C	Cancelled
8	End Date:									NS	No show
9
10	Session #		1	2	3	4	5	6	7	8	9	10	11	12	13	14	Change	# Absences
11	Date		1/1
12		Patient
13	Ex:	John D.	79	81	Y	75	NS	74	70	66	C	64	61	59	55	57	22	2
14
15	1																0
16	2																0
17	3																0
18	4																0
19	5																0
20	6																0
21	7																0
22	8																0
23	9																0
24	10																0
25	11																0
26	12																0
27	13																0
28	14																0
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31		Measure		Range
32		PCL-5		0-80
33		PHQ-8/PHQ-9		0-24/0-27
34		GAD-7		0-21
35		ISI		0-28
36		AUDIT-C		0-12
37		BASIS-24		0-96
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