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Section I: Reason for Service. Click "Finish" to register your data and
continue.
DIAGNOSTIC ASSESSMENT
Section I: Reason for Service
Diagnostic Record ID:
0518200650029
Clinician 1: clovelac
Provider: 000143
Date: 06/07/2006
Time: 9:26
Physician:
Provider:
Date:
Time:
Why are you here today? In consumer's own words, describe presenting
problems, symptoms, precipitating events, source of distress, onset and duration.
Enter the
reason clt is here today. For practice click in the box and type "Depression -
worse over the past few months. Numerous situational stressors. Death of
father, clt cared for father through hospice before he died. Family made clt
promise to care for mother."
1020 character max.
Current psychotropic medications (including recommended dosages):
Enter any
current psychotropic meds. For practice click in the box and type "Zyprexa 5 mg
one tab at bedtime."
1020 character max.
History of previous psychiatric treatments including hospitalizations and
psychotropic medications:
Enter history
of previous psychiatric treatments. For practice click in the box and type "Clt
has never been hospitalized but was on Zoloft about a year ago."
1020 character max. Additional textbox
Has previous treatment benefited you?:NO
YES
Enter
whether the previous treatment had benefited clt. For practice select
"YES" by clicking in the box to the left of it.
Response to previous treatments:
Enter any
response to previous treatments. For practice click in the box and type "The
Zoloft worked well but clt thought she could handle life without it and stopped taking
meds."
1020 character max.
Family history of mental health issues:
NO
YES
Enter whether there is any family history of mental health issues. For practice
select "YES" by clicking in the box to the left of it.
Description
of family history of mental health issues?:
Enter a
description of any family history of mental health issues. For practice click in the
box and type "Grandmother was diagnosed with Bipolar Disorder and a cousin is
manic-depressive."