[Navigation] Global Search > Patient > Case Review
[Accordion] Overview
The Case Review form provides a structured way to document a patient’s progress, evaluate treatment goals, and outline recommendations for ongoing care. Typically completed at designated points in a patient’s journey, it ensures that each review is thorough, reflective, and tailored to the individual’s needs.
[Permissions] The staff member must have Full permissions to the Paperwork module to access the Case Review form [Staff > Staff Info > System Permissions > Paperwork]
[Tip] If you see different labels than what is shown in this article (e.g., Patient vs Client), your system may have Custom Labels applied. You can verify and update these by locating "Custom Labels" in the Global Search.
[Accordion] Getting Started
The Case Review is designed to capture patient progress, evaluate treatment goals, and guide future care at key points in treatment.
Record Details:
Modules (required): Specifies the clinical module to which the case review belongs.
Report Date (required): Select the date of the case review.
Clinician: Select the Clinician handling the case review.
Supervisor: Select the supervisor overseeing the case review.
Case Review tab:
Initial Case Presentation: Marks whether the review is being conducted following the patient’s initial intake.
Status Review: Marks that the review is focused on monitoring the patient’s treatment progress and current status.
Change of Treatment Goals: Indicates if treatment goals need revision or updating.
90 Day Review of Case: Indicates if the case is being reviewed after 90 days of patient intake.
Participants/Title: Enter the names of the participants involved in the case review.
Notes/Progress: Provides a space to record a summary of the case review and patient progress.
Recommendations: Use this field to document any care or treatment recommendations arising from the case review.
Sensitive Information: Indicates that the provided information is sensitive
[Accordion] FAQs
[Q] Can more than one type of review be selected at a time?
[A] Yes. If applicable, you may select multiple review types, such as Status Review and Change of Treatment Goals.
[Q] What counts as Sensitive Information?
[A] Any detail that is confidential, personal, or may require specific permission to access (e.g., legal matters, family incidents) should be marked as including Sensitive Information.
[Q] Who can complete a Case Review form?
[A] A clinician responsible for the patient's care should complete the form. A supervisor may be included if oversight is required.
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