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Choice Program - Progress Summary 2026
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- Click ‘Get Form’ to open the Choice Program - Progress Summary in the editor.
- Begin by entering the Veteran’s Name and DoD ID/Benefits # or Sponsor SSN in the designated fields at the top of the form.
- Fill in the Date Completed and VA Auth Number to ensure accurate tracking of services.
- Provide the Veteran’s Address, City, State, Zip, and Telephone number for contact purposes.
- Indicate whether there is Other Insurance by selecting 'yes' or 'no', and specify if applicable.
- Complete sections for Patient DOB, Service Branch, Provider Name, License Type, and Provider Contact Information including Telephone and Address.
- Document any DSM-V Diagnosis and Co-Occurring Medical Conditions relevant to treatment.
- Answer whether the patient has had a psychiatric hospitalization in the last 90 days by selecting 'yes' or 'no'.
- List Dates of Service along with corresponding Service (CPT Code) and Service Description for each entry.
- Summarize Treatment Progress and note any Treatment Plan Changes as necessary before signing.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2015 | 4.7 Satisfied (25 Votes) |
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