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1. Date (Required.)

Date

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2. Important insights and/or skills resulting from this session are: (Required.)

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3. An example of how I intend to apply the insights and skills from CCS that I have learned today as I execute my my role as a direct support professional, coordinator, manager, or clinician is: (Required.)

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4. The number of times since our last session that I practiced mindfulness was: (Required.)

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5. My level of preparation (e.g. reading) for today’s session was: (Required.)

T