Fillable Form Treatment Plan Template

What is a Treatment Plan Template?

A Treatment Plan is a structured form that contains information on the medical condition of the client, the possible methods for treatment and any side effects, the goals of the treatment, and the estimated period of treatment. As a form, it does not ask for much identifying information besides the client’s name. However, depending on the nature of the treatment and whether or not others are involved in it, information like one’s home address may need to be shared with medical personnel, though it will not be written on the treatment plan itself. Any other information that may be requested as part of a treatment plan will generally be up to the discretion of the doctor.

Treatment plans are often given by doctors in order to ensure that the client is reminded of any particular things they need to do as part of their treatment. Treatment plans vary from person to person, depending on the assessment of the doctor giving them. They can be used to outline the treatment and any other procedures needed for a wide variety of health issues, from conditions like diseases and congenital conditions to mental health problems like depression or even possible post-surgery treatment and care.

The purpose of having a plan of treatment is to ensure that any and all treatments applied to a client are maintained for as long as it takes for the client to make a full recovery. It also serves as a useful record of the current (or recently past) medical history of the client, in the event that they must be examined again for either the same or a different reason, or if a different course of treatment is to be pursued for the client due to the current one not working or having unmanageably negative side-effects.

It is important to maintain treatment as it is prescribed in order to ensure that the treatment works properly, and that a client’s condition does not get worse. This is especially true for treatments that involve drugs like antibiotics or immunosuppressants, as their effectiveness depends on them being used as prescribed. Doctors can then consult the details outlined in the treatment plan if there are adjustments needed to the treatment. For this reason, treatment plans are important not just for the client, but for the doctor as well.

Who needs to use a Treatment Plan Template?

Treatment plans can be used for almost any condition that requires any kind of treatment, and can cover treatment that takes place over the span of a few days to years.

• Doctors and other healthcare personnel give clients treatment plans to remind them about the treatment procedures they need and the goals of the treatment(s) they are going through. They may also use treatment plans as part of a client’s medical history, which can then provide information for use when the client needs additional or different treatment for any reason.

• Clients make use of treatment plans as guides for how they should go about being treated. Often, a client will be given a range of treatment options to choose from, and the doctor will create a treatment plan based on what they know about the client. Treatment plans are also useful as proof that a client is undergoing treatment based on advice from a medical professional.

How to fill out a Treatment Plan Template?

While this treatment plan form is very easy to fill out, it is likely best for both doctor and client to be present or at least readily available in order to ensure that the correct information is being entered. Other people, such as family members and significant others, may also be invited to take part in the treatment planning process.

In addition, make sure that the client not only has a copy of the treatment plan, but also any other documents they might need as part of obtaining the necessary medicine or otherwise for treatment. This could be anything from prescriptions to medical certification that allows certain procedures to be performed with the client’s consent. These documents can be attached to the treatment plan for ease of access when they are needed.

Client Name

Enter the client’s full name.

Counselor’s Name

Enter the name of the counselor attending to the client.

Date

Enter the date that the treatment plan was made.

Problem Statement

Enter a short description of all issues encountered by the client (i.e. reports having constant coughs and colds, itchiness, diagnosed conditions) and the date when the issues were reported. For this step and the rest of the form, use extra paper as needed.

Goals

Enter the goals of the treatment plan. These goals will depend on the treatment method(s) that the counselor decides to employ, so make sure to consult with them to confirm what the goals or desired results of the treatment are.

D/C Criteria

Enter “Required” if the Objective to the right is a necessary and important part of the client’s treatment. Otherwise, enter “Optional”.

Objectives

Enter in each space what the client needs to do as part of treatment, how often, and in what circumstances the client should say or do something.

Common things that clients need to do that are included in this section include seeing a medical professional for a diagnosis, and complying with treatment recommendations as given by the medical professional. These objectives should help the client towards achieving the goals of the treatment as entered above.

Interventions

Enter in each space what the counselor or other medical professional will do to assist the client as part of their treatment process.

Medical professionals will usually arrange for clients to have appointments with other doctors, for specific operations to be performed, give prescriptions for medicine, or give specific instructions to the client or their caretaker on how to administer medicine or how to properly perform any necessary parts of the treatment. These interventions should help the client in achieving the goals of the treatment.

Service Codes

Enter the service code corresponding to the type of intervention being performed here.

Service codes are located at the bottom of the form.

Target Date

Enter the targeted date by which the intervention should have been finished.

Resolution Date

Enter the date when the intervention was finished.

Participation in Treatment Planning Process

Enter the extent to which the client was involved in the process of creating this treatment plan and if the client is aware and approves of the contents of the treatment plan.

Participation by Others in Treatment Planning Process

Enter the extent to which other parties, like family members, or spouses, were involved in the process of creating this treatment plan, and if they agree with this plan.

Client Signature/Date

Enter the client’s signature and the date that the treatment plan was signed.

Counselor Signature/Date

Enter the counselor’s signature and the date the treatment plan was signed.

Tips when filling out a Treatment Plan Template

Treatment plans are very simple forms to fill out. However, because of how important following a treatment plan can be for the client’s health, it is important to make sure that the correct information is being entered so that the appropriate treatment procedure(s) can be planned out.

Ensure that information on the client’s problems is accurate. This is critical, as without the proper information on the issues the client is experiencing, the treatment plan cannot be properly made. Thus, it is the client’s responsibility to provide the information that the counselor asks for in relation to their current condition.

Keep a copy or two of the plan in a safe place. For both the client and the counselor, it is best to have these copies so that they can be consulted at a later date should the client or the counselor wish to re-examine the treatment plan for any reason. For the client, having a backup copy is also important in the event that they lose their copy of the treatment plan, as then they will not have to return to the doctor to get a new one.

Follow the plan. The client should follow the plan as much as possible to ensure that there are no issues in the treatment. This includes taking medicine when scheduled, going to the appropriate doctors as advised, and anything else that is outlined in the treatment plan’s “objectives” section.