CLEVELAND CLINIC HOME CARE PAGE 1 OF 3 SPEECH THERAPY DISCHARGE SUMMARY Circle Team: N1 N2 N3 N4 T1 T2 T3 T4 Other Disciplines still Active SOC: SN OT S 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by circling the appropriate team from the options provided (N1, N2, N3, N4, T1, T2, T3, T4) and indicate any other active disciplines.
  3. Fill in the SOC (Start of Care) date and check the relevant disciplines still active such as SN (Skilled Nursing) or OT (Occupational Therapy).
  4. Select a discharge reason by checking one of the options listed under 'DISCHARGE REASON'.
  5. Complete the goals for treatment section by indicating status using A (Achieved), PA (Partially Achieved), or NM (Not Met).
  6. Provide patient details including name and therapist information at the end of the form.

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