Protocol example therapeutic recreation

Instead of reinventing the wheel, take a look at the forms, policies, procedures, and manuals used in therapeutic recreation service, take a look at what's available here and adapt it to your own use.

Submit your forms and formats to charlie*recreationtherapy.com and have it posted here for others to review and adapt in their workplace. (note - replace the * with the @ symbol before emailing.)

Note: many of these forms are in Word for Windows format

Activity Analysis Forms and Formats

• On Deck 2 (leisure education) by Denise L Blanchfield

Assessment Forms

• Adolescent Assessment Form
• Brief Client Activity Survey by Robert Pressley
• Recreation Therapy Assessment/Treatment Plan by Pat Black, CTRS
• Therapeutic Recreation Resident Assessment by Charles Sourby
• RT Assessment by Donna Case (a modification of Charles Sourby's assessment)
• Therapeutic Recreation Assessment Summary Report and Treatment Plan

Consent Forms

• none listed - please submit one.
  

Consult Report Formats

• Sample Consult Report by Charles Dixon
• Consult Report on patient with substance problem

Continuing Education

• Study Guide for NCTRC exam by by Charles Sourby and Michaela Byrnes

Discharge Planning Forms

• Discharge Summary submitted by Pat Black, CTRS

Evaluation Forms and Formats

Internship Forms/Manuals

• Internship Application Form
• Internship Application Form by Waverly Heights
• Internship Evaluation Form by Patricia Malik, CTRS

Observation Record Forms

• Sensory Program- Record of Resident Responses by Kimberly Grandal, CTRS

Policy and Procedure Samples

Position Statements

• none listed - please submit one.

Protocol Formats

• Coping Skills
• Outings Protocol submitted by Charlie Dixon

Referral Forms

• TR Referral Form used in a nursing home- by Linda Buettner

Quality Assurance, Program Evaluation

• Developing an Activity Room- Basic list of equipment by Robert Pressley
• TR Program Evaluation by Charles Sourby

Program Planning

• Therapeutic Recreation Program Planning form by Charles Sourby
• The Formative Program Evaluation Procedure Program Plan Description Form by Charles Sourby

Safety Procedures & Protocols

• Activity Area Safety Policy & Procedures
• Answers to Dangerous Situations/Emergencies 1
• Answers to Dangerous Situations/Emergencies 2

Treatment Plan Forms and Formats

• Care Plan Maintenance Form by Charles Sourby