Psych progress notes template

Day X
Meds

Subjective

• What they tell you
  

Objective

• MSE

Assessment

• What do they have? Are they getting better/worse?
  

Plan

1. care level
2. leave
• unescorted x __ hrs
• escorted x __ hrs with ____
3. Medications - any new ones/stopped ones/changes in doses?
   
4. Investigations
5. Other things that need to be done e.g. call GP, family members etc..