Behavioral Health Chart Audit
Audit tool for reviewing behavioral health patient charts against documentation standards
Audit Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Auditor Name
*
First Name
Last Name
Chart Identifier
*
Patient Initials or Chart Code
*
Service Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Documentation Areas Reviewed
*
Assessment
Treatment Plan
Progress Notes
Discharge Summary
Consent Forms
Other
Completeness Rating
*
Incomplete
1
2
3
4
Complete
5
1 is Incomplete, 5 is Complete
Compliance Findings
*
Compliant
Partially Compliant
Non-Compliant
Corrective Action Needed
*
Yes
No
Auditor Comments
Submit Audit
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