BASIS Tracking Logs

The following downloadable files are examples designed by the Cottonwood CDDO for use in tracking behaviors and seizures to serve as documentation for the BASIS Assessment. In order to capture behaviors in the BASIS assessment there must be documented proof of their occurrence.  These forms or something similar should be used to document behaviors in all settings (Home, Community, School, Day services, Job, etc.)  

NOTE: Behavior Tracking is not necessary for individuals with a Tier 1-5, who are also not currently recieving HCBS funded Day, Residential or In-Home Supports. An annual BASIS re-evaluation will not be completed on these individuals until funding is offered. If you have any questions about whether or not you should be tracking behaviors contact your Case Manager or the CDDO.
Behavior Trackings:
  12 page version: PDF Excel  (One page per month, provides a Month-at-a-Glance View)
  4 page version:  PDF / Excel (2 pages front & back that provides a Year-at-a-Glance View)
  2 page version: PDF / Excel (Very compact 1 page front and back version, Year-at-a-Glance View)
  Old version: PDF / Word (The older 12 page version, provides a Month-at-a Glance View)
  Fax version: PDF / Excel (Printable PDF file designed to be easier to read for faxing purposes)
  Versión Española: PDF (Registro del comportamiento en español)
  Behavior Definitions PDF (Descriptions of each behavior)

Seizure Tracking:
1 page version: PDF / Excel (One page per year, Seizure frequency tracking log for the BASIS Assessment).