Different therapy note formats require different documentation elements. These format-specific checklists help ensure your notes are complete regardless of which format you use.
Part of our therapy documentation best practices guide.
Subjective — client-reported symptoms, concerns, experiences
Objective — therapist observations, behavior, affect, engagement
Assessment — clinical interpretation, progress, diagnostic impressions
Plan — next steps, homework, follow-up schedule
Data — combined session observations and client reports
Assessment — clinical interpretation and progress toward goals
Plan — next steps, interventions, and follow-up
Behavior — client presentation and observable behaviors
Intervention — specific therapeutic techniques used
Response — client reaction to interventions
Plan — next steps and treatment direction
Client identifier and session date
Session duration and type
Presenting concerns
Interventions named specifically
Progress toward goals
Risk assessment when indicated
Clear next-steps plan
Choose your documentation format based on your practice needs:
SOAP — when your setting requires structured separation of observations
DAP — when you need fast, concise documentation
BIRP — when tracking interventions and behavioral responses is priority
Progress Notes — when flexibility is more important than rigid structure
Any format consistently — consistency matters more than format choice
No credit card required.
Use the checklist that matches your documentation format (SOAP, DAP, or BIRP). The universal checklist applies to all formats.
Consistency is recommended, but some therapists use different formats for different session types.
The universal checklist covers essential elements regardless of format.
Generate structured therapy notes in minutes — no session recording required.