HEALTH HISTORY (You are also required to complete a medical examination and a mental health evaluation, which have separate forms.) Please describe your current physical and mental health. List any current medications you take:  No Yes Do you have any physical challenges?  No Yes Have you ever been treated for a serious illness or injury?  No Yes Do you have any learning disabilities?  No Yes Have you ever been treated for mental illness or emotional disturbance?  No Yes Are you presently undergoing therapy or counseling?  No Yes Have you ever been treated for substance abuse? (If you answered YES to any of these questions, please describe below. Use additional sheets of paper if necessary.)
HEALTH HISTORY (You are also required to complete a medical examination and a mental health evaluation, which have separate forms.) Please describe your current physical and mental health. List any current medications you take: Do you have any physical challenges? No  Yes Have you ever been treated for a serious illness or injury? No  Yes Do you have any learning disabilities? No  Yes Have you ever been treated for mental illness or emotional disturbance? No  Yes Are you presently undergoing therapy or counseling? No  Yes Have you ever been treated for substance abuse? No  Yes (If you answered YES to any of these questions, please describe below. Use additional sheets of paper if necessary.)
History_Packet_and_Spiritual_Autobiography_for_Discerning_Holy_Orders.docx