Substance Abuse Rehabilitation Case Closure Report
Client Information
Client Name
Date of Birth
Client ID/Case Number
Admission Date
Discharge Date
Treatment Overview
Primary Substance(s) of Abuse
Treatment Modality
Frequency & Duration of Treatment
Presenting Issues
Treatment Progress & Outcomes
Summary of Treatment Provided
Goals Achieved
Remaining Challenges/Unmet Needs
Client’s Participation Level
Relapse or Setbacks (if any)
Support Systems (family, community, etc.)
Reason for Case Closure
Aftercare & Referrals
Aftercare Plan
Referrals (agencies, services, etc.)
Additional Notes / Recommendations
Prepared by
Designation
Date