Appropriate Being Irritable Having Trouble Concentrating Bright Labile Withdrawn Distressed Expressing Loss of Pleasure Expressing Worthlessness Fatigued Being Sad Expressing Worry Flat Difficult or Unable to Assess Suicidal Ideation/Intentions: Frequency of occurrence: How long does it last: Intensity of suicidal thoughts: Reasons individual would rather die than live: Detailed Plan: Plan location: How lethal is the method: Access to lethal methods: If firearms, are they being removed from patient access: Steps taken to enact plan: Rehearsal behaviors: Obtained access: Details: Thought Process: Blocking Evasive Neologisms Circumstantial Flight of ideas Perseveration Clang Associations Incoherent, Logical Rational Coherent Loose Associations Tangential Egocentric Magical thinking Word Salad Test Results and Interpretation: (add as needed) Problem List: Lipids Diabetes mellitus Mood disorder Learning problems Heart disease Hyperlipidemia Personality disorder Cognitive impairment Obesity Seizure disorder Thought disorder Compliance difficulties TIA / stroke Sedentary lifestyle Dementia Social isolation Hypertension Gastrointestinal problem Additional Comments: Diagnosis: Treatment Plan/Recommendations:
Appropriate Bright Distressed Fatigued Flat Being Irritable Labile Expressing Loss of Pleasure Being Sad Having Trouble Concentrating Withdrawn Expressing Worthlessness Expressing Worry Difficult or Unable to Assess Suicidal Ideation/Intentions: Frequency of occurrence: How long does it last: Intensity of suicidal thoughts: Reasons individual would rather die than live: Detailed Plan: Plan location: How lethal is the method: Access to lethal methods: If firearms, are they being removed from patient access: Steps taken to enact plan: Rehearsal behaviors: Obtained access: Details: Thought Process: Blocking Circumstantial Clang Associations Coherent Egocentric Evasive Flight of ideas Incoherent, Logical Loose Associations Magical thinking Neologisms Perseveration Rational Tangential Word Salad Test Results and Interpretation: (add as needed) Problem List: Lipids Heart disease Obesity TIA / stroke Hypertension Diabetes mellitus Hyperlipidemia Seizure disorder Sedentary lifestyle Gastrointestinal problem Mood disorder Personality disorder Thought disorder Dementia Learning problems Cognitive impairment Compliance difficulties Social isolation Additional Comments: Diagnosis: Treatment Plan/Recommendations: