SIRP Note Template

A SIRP note records a session in four parts: the Situation that brought the client in, your Intervention, the client’s Response, and the Plan. Copy the free template, see a school counseling example and an adult example after a job loss, and check what goes in each part.

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Blank SIRP note template

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SIRP NOTE

Client: [Name, initials, or ID]
Date and time: [Date, start and end time, total minutes]
Contact type: [Scheduled session, extra session, walk-in, crisis contact, phone check-in, or case management visit]
Setting: [Office, school, home, shelter, community site, or video, with the client's location if remote]
How the contact started: [Who asked for it: the client, a parent, a teacher, a referrer, or you]
People involved: [Anyone else present or contacted, by role]
Staff: [Your name, credentials, and role]

SITUATION
What brought the client in: [The event, change, or problem behind today's contact, and when it happened]
In the client's words: [A short quote on what is going on and what they want from today]
Other sources: [What a parent, teacher, referrer, or record added, and the consent for it]
How the client arrived: [Appearance, behavior, speech, mood in their words, affect, and a distress rating if used]
Pressing needs: [Safety, housing, food, money, school or job standing, health, or none]
Plan link: [The treatment, service, or school plan goal this touches, or new and not on a plan]

INTERVENTION
Steadying steps: [What you did first: space, water, grounding, validation, slowing the pace]
Risk check: [Your questions on suicide, self-harm, harm to others, and safety at home, with the answers]
Main work: [Each step by name: problem-solving, skills coaching, safety planning, lethal means counseling, psychoeducation, advocacy, or linkage]
Contacts made: [Calls, messages, or referrals during the contact, to whom, and under what consent]

RESPONSE
Change by the end: [Distress, urge, or another rating at the start and at the end]
Choices made: [What the client agreed to, chose, or declined]
Client's view: [What the client said about the help, in their words]
Where things stand: [The situation now: resolved, eased, unchanged, or worse, and your risk judgment with reasons]

PLAN
Client steps: [Each thing the client will do, and by when]
Staff follow-up: [Your calls, referrals, letters, or meetings, each with a date]
Safety arrangements: [Safety plan reviewed or updated, means made safer, crisis numbers given, or not needed]
Next contact: [Date, time, place, and who will reach out]
Plan update: [A new goal for the treatment or service plan, or no change]

Signed: [Name, credentials, date and time]

Use it for

  • Walk-in and crisis contacts
  • School counseling
  • Case management
  • Outpatient therapy
  • Social work visits

Two filled examples. Every part, filled in.

Each one follows the template. Use them to judge how much detail every part needs.

SIRP note: a student sent out of class after a conflict with a teacher

High school counseling office, same-day contact, 35 minutes

Contact details

Same-day contact in the school counseling office, 10:20 to 10:55 a.m., during second period. Sent by the assistant principal after an incident in English class. 16-year-old girl in grade 11, known to the counselor from course planning only; no past counseling. Seen alone.

Situation

In English this morning, her teacher asked her twice to put her phone away. When asked to hand it over, she said “you don’t even know what’s going on,” swore, and slammed her binder on the desk. The teacher sent her to the office. In her words: “My brother’s school couldn’t reach my mom, so they called me. I was trying to get my grandma to pick him up.” Her 8-year-old brother had been sent home with a fever. Background: her mother started night shifts at a care home 3 weeks ago and sleeps in the mornings. Since then she gets her brothers, 8 and 11, up and onto the bus, and finishes homework after midnight; about 5 hours of sleep on school nights. Late to first period twice this month, one missed English assignment, no past discipline. The teacher’s email to the office: “Not like her at all.” Arrived red-faced, arms folded, jaw tight; tearful within a few minutes. Speech fast and loud at first. Mood “so done”; affect angry, then sad. Distress 8 out of 10. Pressing need: her brother. Her texts showed her grandmother collected him at 10:05. Plan link: none; not on a counseling or school plan.

Intervention

Gave her a few minutes and a glass of water before talking. Validated that she was trying to look after her brother. Grounding with the 5-4-3-2-1 senses exercise, then slow breathing. Once calmer, went through the class step by step: what she needed, what her teacher could see from the front of the room, and what she could do next time, such as asking to go to the office to make the call. Risk check: asked about thoughts of suicide, self-harm, and hurting anyone, and whether she feels safe at home. She denied all, and said her mother is “just tired, not mean.” Problem-solving on mornings: listed her tasks from 6:30 to 8:15 a.m. and which ones her 11-year-old brother could take on. Explained how a restorative meeting with a teacher works. Asked what, if anything, she wanted her teacher told.

Response

Distress 3 out of 10 by the end, from 8. Speech slowed. Said without a prompt, “I shouldn’t have sworn at her.” Wrote 3 lines she wants to say to her teacher. Chose 2 morning jobs for her 11-year-old brother: packing lunches the night before, and walking the 8-year-old to the bus. Agreed that her teacher can know her family’s schedule has changed, and nothing more. Declined a referral to the school social worker for now: “Let me see if mornings get better.” Judgment: a single outburst driven by caregiving load and short sleep, not a pattern of conduct problems. No safety concerns. The moment has eased; the cause, mornings and sleep, is not solved yet.

Plan

Student: say her 3 lines at the restorative meeting, start the new morning jobs tomorrow, and come to the office to call home if a family emergency comes up in class. Counselor: email her teacher today to set the meeting for tomorrow at 8:05 a.m., sharing only the schedule change, and ask about 2 extra days for the missed assignment. Tell the assistant principal she was seen and has settled; any consequence stays with the assistant principal. Call her mother after 2 p.m., with the student’s agreement, about mornings and the school’s family support options. Next contact: check-in Friday at lunch; the counselor will send a pass. If lateness and sleep haven’t improved in 2 weeks, offer the school social worker again.

What goes in each part.

Contact details

The facts of the contact, and how it came about. Situation-driven contacts are often unplanned, so say who asked for this one.

  • The date, start and end time, and total minutes
  • The kind of contact: scheduled, extra, walk-in, crisis, phone check-in, or case management visit
  • Where it happened, and for video, where the client was
  • Who asked for the contact, and anyone else present or contacted

Avoid: Leaving out how the contact started. “Sent by the assistant principal” or “asked for an extra session after a bad night” tells the next reader why the note exists.

Situation

What is happening for the client now: the event or circumstance behind today’s contact, and how they arrived. This is what sets SIRP apart. It starts from the client’s present situation, not from a plan goal or an observed behavior.

  • The event or change, and when it happened
  • The client’s account, in a short quote
  • What others added, such as a parent, teacher, or referrer
  • How the client presented, with a distress rating if you use one
  • Pressing needs: safety, housing, food, money, school, or work
  • The plan goal it touches, or a note that it is new

Avoid: The whole life story. Write what bears on today, and leave the background to the intake or the biopsychosocial assessment.

Intervention

What you did, in the order it mattered: steadying the moment first, then the risk check, then the main work.

  • Steps to calm or contain: space, grounding, validation
  • The risk questions you asked, and the answers
  • Each technique or service by name: problem-solving, safety planning, lethal means counseling, advocacy, or linkage
  • Calls, messages, and referrals made, and the consent behind each

Avoid: “Provided crisis support.” Say what you did, so a colleague could pick up where you left off.

Response

How the client, and the situation, changed by the end of the contact, and your judgment of where things stand.

  • A rating at the start and at the end: distress, urge, or another measure
  • What the client chose, agreed to, or declined
  • The client’s own words about the help
  • Whether the situation is resolved, eased, unchanged, or worse
  • Your risk judgment, with the reasons

Avoid: “Client calmed down.” Give the before and after numbers, and say whether the cause is solved or only the moment.

Plan

Who does what next, by when, and what keeps the client safe until then.

  • The client’s steps, each with a time
  • Your follow-up tasks, each with a date
  • Safety plan changes, safer storage of means, and crisis numbers
  • The next contact, and who starts it
  • Any change the treatment or service plan needs

Avoid: Stopping once the crisis eases. A situation-driven contact needs a follow-up date, or the same situation returns as the next crisis.

Common mistakes, and how to avoid them.

A situation with no event

“Client upset” could describe any day. Write what happened, when it happened, and what the client wants from this contact.

Skipping risk on a practical visit

A layoff, an eviction notice, or a suspension can change risk fast. Ask every time, even when the visit is about paperwork, and record the questions and the answers.

Settling the moment, not the cause

A student who calms down in your office still faces the same mornings tomorrow. Name the cause under Response, and give it a step in the Plan.

Telling school staff too much

A teacher may need to know that a student’s family schedule changed, not why. Agree with the student on what will be shared, and write that down.

New problems left off the plan

When a situation brings out something new, such as suicidal thoughts or heavier drinking, record it and add a goal to the treatment plan at the next session.

Say what happened. Review the SIRP note.

Vero Scribe writes the SIRP note in your template from the session, with the client’s consent, or from your dictation afterward. You review and edit every section, then copy it into your record or export it to Word or PDF. Vero works in 60+ languages.

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Frequently asked questions.

What does SIRP stand for?

Situation, Intervention, Response, and Plan. Situation is what is happening for the client now and what brought them in. Intervention is what you did. Response is how the client and the situation changed, with your judgment of risk. Plan is who does what next, and when.

How do you write a SIRP note?

Start with the event or circumstance behind the contact, the client’s own words, and how they arrived. Record what you did to steady things, the risk questions and answers, and the main work. Then give a rating at the start and end, what the client agreed to, and where things stand. Finish with each person’s next steps and the next contact.

How is a SIRP note different from SOAP, DAP, BIRP, and GIRP notes?

The first heading is the difference. SOAP splits what the client reports from what you observe. DAP puts both in Data, then your Assessment. BIRP opens with the client’s behavior and presentation, and GIRP with the treatment plan goal. SIRP opens with the situation: the event or circumstance behind today’s contact. Its last three headings match BIRP and GIRP.

When is a SIRP note the best fit?

When something that just happened drives the session, rather than the next step in a plan: walk-ins and crisis contacts, case management visits about housing, money, or school, and school counseling, where students often arrive after an incident. For steady weekly therapy against plan goals, a GIRP or DAP note may fit better.

Is this SIRP note template free?

Yes. Copy it, or download it as a Word or text file. No account needed.

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