SOP_NUMBER: 508.07-att-3
TITLE: Record of Individual Clinical Case Consultation
REFERENCE_CODE: VG15-0001
DIVISION: Mental Health Services
TOPIC_AREA: 508 Policy-MH Administration/Staff/Certification
EFFECTIVE_DATE: 2022-08-15
WORD_COUNT: 77
POWERDMS_URL: https://public.powerdms.com/GADOC/documents/267413
URL: https://gps.press/sop-data/508.07-att-3/

SUMMARY:
This form documents individual clinical case consultations conducted within the Georgia Department of Corrections Mental Health Services. It records consultation sessions between staff members and clinical consultants, including offender case information, clinical issues discussed, and session details. The form serves as an official record maintained by the mental health unit manager or consultant for documentation and retention purposes.

KEY_TOPICS: clinical case consultation, mental health services, offender mental health, clinical consultation record, case discussion, mental health staff, consultant documentation, MH services documentation, clinical consultation form, case consultation tracking

ATTACHMENTS:
  1. Record of Clinical Supervision
     URL: https://gps.press/sop-data/508.07-att-1/
  2. Semi-Annual Report of Clinical Supervision
     URL: https://gps.press/sop-data/508.07-att-2/
  3. Record of Individual Clinical Case Consultation
     URL: https://gps.press/sop-data/508.07-att-3/
  4. Clinical Group Case Conference Record (Attachment 4)
     URL: https://gps.press/sop-data/508.07-att-4/

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FULL TEXT:
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SOP 508.07
Attachment 3

8/15/22


**GEORGIA DEPARTMENT OF CORRECTIONS – MENTAL HEALTH**
**SERVICES RECORD OF INDIVIDUAL CLINICAL CASE CONSULTATION**

Institution: Date of Session:

Staff Member: Consultant:

Start Time of Session: End Time of Session:

Offenders/Cases Discussed:

|Name|ID#|Name|ID#|
|---|---|---|---|
|||||
|||||
|||||



Clinical Issues/Concerns:

Clinical Consultant Signature Date


Form no. M15-01-03 Page 1 of 1

Retention Schedule: Upon completion, this form will be maintained by the mental health unit manager and/or consultant until obsolete
or replaced.