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]