Monthly Resident Progress Review Form

This form is completed monthly by the Resident's counsellor or mentor, in consultation with the Resident, and is reviewed by the Facility Manager. The completed form is filed in the Resident's record and informs the recovery plan, leave decisions and the level of support provided in the coming month.

SECTION A — IDENTIFICATION

Review Month Beginning (1st of the month) *Review Month Ending (last day of the month)Resident Full NamesR2R-ID / Identity Number / Resident Reference *Date of AdmissionDays in Residence to DateRoom NumberCounsellor / Mentor Conducting the Review *Date of Last Monthly Review

SECTION B — WELLBEING (MONTHLY OVERVIEW)

Ratings reflect the dominant pattern across the month, not a single day. Note significant changes within the month in the Notes column.

Dimension	Resident's Self-Rating (1–10)	Staff Rating (1–10)	Notes
Mood
Sleep
Appetite
Physical energy
Anxiety
Cravings
Sense of safety
Hope for the future
Connection with others
Spiritual / inner life

Significant events affecting wellbeing this monthIndicators of self-harm or suicidal ideation noted (Yes / No, action)

SECTION C — SOBRIETY AND TESTING

Days of continuous sobriety as at the end of this monthTests conducted this month (dates and results)Cravings reported this month (frequency and intensity)Triggers identified this monthCoping strategies usedRelapse risk assessed this monthAny near-relapse, cross-addictive or boundary issue noted

SECTION D — PROGRAMME PARTICIPATION

Record attendance against the typical monthly schedule for each programme component.

Component	Sessions Scheduled (month)	Sessions Attended (month)	Engagement (Low / Medium / High)	Notes
Morning check-in
HEAL meetings
NA meetings (on-site)
NA meetings (off-site)
Addiction counselling
Trauma counselling
Mentorship sessions
Yoga / Meditation / Mindfulness
Exercise / Sport
Employment readiness
Speaker programme
House meetings
Chore rotation

Highlights of the Resident's participation this monthConcerns about the Resident's participation this month

SECTION E — MEDICAL AND MEDICATION

Medical events this month (illness, injury, appointments)Medication changes this monthCompliance with weekly medication packs this month (Compliant / Concerns)Side-effects or adverse reactions reportedVisits with the emergency doctor or homeopath this monthPharmacist communication this month

SECTION F — CONDUCT

House Rule breaches noted this monthDisciplinary action taken this monthSmoking infringements / penalty appliedConflict or relational issues this monthContribution to the residence this month

SECTION G — LEAVE AND VISITORS

Leave taken this month (dates and times)Tests on return from leave (dates and results)Visitors received this monthIssues arising from leave or visitsApproved additional visitors for the coming month

SECTION H — REINTEGRATION AND EMPLOYMENT READINESS

Curriculum vitae progressJob search activities this monthNGO or employer partner engagementsSkills or training pursued this monthReintegration goals reviewedFamily or relationship work pursued this monthFinancial planning / debt management progress

SECTION I — RECOVERY PLAN REVIEW

Goal from Last Month's Review	Progress This Month	Owner	Status (On Track / Slipping / Achieved / Revised)

Goals for the Coming Month

Goal	Action	Owner	Review Date

SECTION J — IN THE RESIDENT'S OWN WORDS

What went well this month?

______________________________________________________________________________________________________________

What was hard this month?

______________________________________________________________________________________________________________

What support do I need next month?

______________________________________________________________________________________________________________

What am I grateful for this month?

______________________________________________________________________________________________________________

SECTION K — COUNSELLOR / MENTOR SUMMARY

Overall assessment of the Resident's progress this monthStrengths observedRisks or concernsRecommended programme adjustmentsRecommended leave decisions for the coming monthRecommended testing schedule for the coming monthRecommended communication with the Responsible Person

SECTION L — SIGN-OFF

Resident

Full NameSignatureDate

Counsellor / Mentor

Full NameSignatureDate

Facility Manager Review

CommentsFull NameSignatureDate