Click the down arrows and select
"3=severe" for the following: Mood Disturbance, Anxiety, Activities of
Daily Living, Medical/Physical Conditions, Job/School Performance, and
Social/Marital/Family Problems. Select "0=none" for the rest.
Activities of Daily
Wieght Loss Assoc.
with Eating D/O:
The information below would only be
there was wieght loss assoc. with
an eating D/O.
Gain or Loss?:
Current weight =
You would click one of
the radio buttons if there was no treatment history or it was unknown. Leave these
blank for training purposes.
Mental Health/Psychiatric Treatment
Click in the box
Click the down arrow
Click the down
and select "Improved".
Click in the radio
Substance Abuse Treatment History:
Click the down arrows
below and select "YES" for "Current psychotropic meds?". Select
"NO" for everything else.
Mandatory workplace referral?:
Is member currently receiving disability benefits?:
Current psychotropic meds?:
** Current medications are
pulled from the Crisis portion of the PCP