Therapy Billing Units Tracking Form
Log and track therapy session details and billing units efficiently.
Therapist Name
*
First Name
Last Name
Client Initials or ID (Do not enter full name)
*
Session Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Session Start Time
*
Hour Minutes
AM
PM
AM/PM Option
Session End Time
*
Hour Minutes
AM
PM
AM/PM Option
Session Type
*
Please Select
Individual
Group
Family
Consultation
Other
Service Code
*
Units Billed
*
Location / Modality
*
Please Select
In-person
Telehealth
Home Visit
School
Other
Authorization Number (if applicable)
Session Notes / Comments
Submit Billing Entry
Should be Empty: