Documentation of Family Training

Documentation of Family Training

Behavioral Services
Individuals Name:*
Training Date*

MonthDayYear
Date
Location of Training*
Trainer: *
Other: *
Training Addressed the Following Items:
Current Behavior Plan dated: *
Psychotropic Medications:
Psychotropic Medications:

YesNo
Data Collection:

YesNo
I acknowledge that family/staff were provided training regarding his/her positive behavioral support program. Training was provided directly (by the clinician/trainer) or indirectly (family/staff reviewed the plan without the clinician/trainer present Family/staff were trained in data collection and how to document each behavior. Training was provided directly (by the clinician/trainer) or indirectly (family/staff reviewed the plan without the clinician/trainer present.

YesNo
The individual's Psychotropic medication treatment program was reviewed including current medications and potential side effects If there is a PRN this process was reviewed to ensure family/staff are aware of the proper procedure Training was provided directly by the clinician/trainer or indirectly family staff reviewed the plan without the clinician/trainer present Family/staff have been made aware of how to contact the Behavior Specialist should any new behaviors arise or further assistance or training be needed.

YesNo
Other (Please note)
By signing below, I acknowledget I understand the above and have received direct or indirect training on Positive Behavioral Support Program, Psychotropic Medications, and Data Collection/Documentation.
Full Name:
Signature
Date

MonthDayYear
Date
Should be Empty:

Documentation of Family Training

Training Addressed the Following Items: