big band intervention - goals on care plan for individual … · title: big band intervention -...

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Resident: Goal -- Resident will show participation by: Goal met? Date: 1. A. Singing B. Playing Instrument C. Other 2. A. Singing B. Playing Instrument C. Other 3. A. Singing B. Playing Instrument C. Other 4. A. Singing B. Playing Instrument C. Other 5. A. Singing B. Playing Instrument C. Other BIG BAND MUSICAL INTERVENTION Blank Sample Form Goals on care plan for individual residents

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Page 1: Big Band Intervention - Goals on care plan for individual … · Title: Big Band Intervention - Goals on care plan for individual residents - Blank Sample Form Author: New York Sate

Resident: Goal -- Resident will show participation by: Goal met? Date: 1.

A. Singing

B. Playing Instrument

C. Other

2.

A. Singing

B. Playing Instrument

C. Other

3.

A. Singing

B. Playing Instrument

C. Other

4.

A. Singing

B. Playing Instrument

C. Other

5.

A. Singing

B. Playing Instrument

C. Other

BIG BAND MUSICAL INTERVENTION Blank Sample Form

Goals on care plan for individual residents

Page 2: Big Band Intervention - Goals on care plan for individual … · Title: Big Band Intervention - Goals on care plan for individual residents - Blank Sample Form Author: New York Sate

6.

A. Singing

B. Playing Instrument

C. Other

7.

A. Singing

B. Playing Instrument

C. Other

8.

A. Singing

B. Playing Instrument

C. Other

9.

A. Singing

B. Playing Instrument

C. Other

10.

A. Singing

B. Playing Instrument

C. Other

Page 3: Big Band Intervention - Goals on care plan for individual … · Title: Big Band Intervention - Goals on care plan for individual residents - Blank Sample Form Author: New York Sate

11.

A. Singing

B. Playing Instrument

C. Other

12.

A. Singing

B. Playing Instrument

C. Other

Other Comments:

Signature: Date: