Client Service Record
An administrative record of service provision under the APS two-file model, completed by the provisional psychologist. This record contains factual service data only. Cases requiring clinical review are routed to your supervisor via the screening step below.
PiS administrative record · Client Service RecordCase screening
Answer every question before the record opens. These confirm whether this case can be recorded administratively or requires supervisor review.
This case requires supervisor review
Do not complete this online form. One or more screening criteria apply, which means this case cannot be finalised as an administrative record.
Please download and complete the supervisor review template instead. Your supervisor will be notified and this case cannot be finalised until they have reviewed and signed off.
Download supervisor review template (PDF)Complete the PDF, then email it to your supervisor with the student ID and school in the subject line.
Service details
All fields required. Factual service data only.
Reason for referral
Check all that apply. This records the referrer's stated reason for requesting the service. At least one required.
Nature of service
Check all that apply. This records what was delivered, as a factual service log.
Service delivery factors
Check all that apply. Logistical factors that affected service delivery. This explains the session count as a factual service log.
Case outcome
Select one. This must match the outcome logged on the monday.com Referrals board.