social work termination note

I need a 1 pg social work termination note that is like a review of the social work class. Summarize presenting problems with course. what goals did you set for yourself in regards to presenting problems? what achievements have you made toward your goals? what recommendation do you have for yourself or for the course? What additional comments do you have?

Example:

https://naswcanews.org/termination-ending-the-therapeutic-relationship-avoiding-abandonment/

Must contain: Summary, Goals, Achievements/ Completion of Goals, Recommendations, and additional comments