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What medications are you taking?
Do you suspect you may have symptoms of a disorder? If so, please list below, and the therapist will evaluate you for any of these.
Over the last 2 weeks, how often have you been bothered by the following symptoms:
0 = Not at all
1 = Several Days
2 = More than Half the Days
3 = Nearly Every Day
Sometimes, things happen to people that are unusually frightening, horrible, or traumatic.
In the past month, have you:
NATIONAL SUICIDE PREVENTION HELPLINE: 1-800-273-8255