Behavioral Counseling Services LLC
30 Day Progress Report
This report should be completed on the 15th of every month for ALL YOUTH and sent to their Case Manager.
LOCATION
SHOULDER'S HOUSE
YOUTH NAME
DATE
-
Month
-
Day
Year
Date
Date Picker Icon
ATTITUDE
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Positive Attitude
Gets along with peers
Completes Chores
Follows Directions
Uses Profanity
Leadership Skills
SCHOOL
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Always On Time
Completes Homework
On Track to Pass
Needs Tutoring
INDEPENDENT LIVING SKILLS
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Life Skills Improved
Social Skills Developed
Cooking Skills Improved
Budget Skills Improved
Nice Clothing Appearance
Great Hygiene
FAMILY
Strongly Disagree
Disagree
Neutral
Agree
Strongly Agree
Positive Interaction with Family Members
Working towards family unification
WORK
Currently Job Searching
Currently Working
Always on time to work
Managing finances properly
Not interested in working
YOUTH IS INVOLVED WITH THE FOLLOWING EXTRACURRICULAR ACTIVITIES
ATHLETICS
ROTC
BAND
COMMUNITY SERVICE
CHURCH
DRAMA
ADDITIONAL COMMENTS/CONCERNS
Case Manager Name
*
First Name
Last Name
Case Manager E-mail
*
COMPLETED BY: (STAFF NAME)
*
Staff Signature
*
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