Calm Resolve Support Log
Please complete this log to document your support session and interventions for calm resolve or conflict management.
Session Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Client Full Name
*
First Name
Last Name
Support Staff Name
*
First Name
Last Name
Session Location or Mode
*
Please Select
In-person
Phone
Video Call
Other
Presenting Issue or Concern
*
Initial Emotional State (Client)
*
Calm
1
2
3
4
Agitated
5
1 is Calm, 5 is Agitated
Interventions or Strategies Used
*
Active Listening
De-escalation Techniques
Problem-Solving Discussion
Referral to Other Services
Other
Outcome of Session
*
Resolved
Partially Resolved
Unresolved
Escalated
Recommendations or Next Steps
Follow-up Required?
*
Yes
No
Additional Notes
Submit Log
Should be Empty: