Work / School SELECT ONE: Regular Attendance Skips Class Not Employed Employed Absenteeism Suspended Seeking Employment Disruptive Expelled Defies Authority Tardiness Dropped Out Poor Performance Illiterate IEP/504 Learning Disabilities No Problem Slight Moderate Serious Severe Extreme justification, explanation, description: (Grade Level) Danger to Others Not Dangerous Physically Aggressive Homicidal Threats Causes Serious Injury Cruelty to Animals Homicide Ideation Uses Weapons Violent Temper Homicidal Attempt Assaultive Sexually Aggressive Accused/Sexual Assault No Problem Slight Moderate Serious Severe Extreme Brief justification, explanation, description: Anxiety Calm Obsessive/Compulsive Panic Attacks Tense Anxious Guilt Phobic Worried/Fearful Anti-Anxiety Meds No Problem Slight Moderate Serious Severe Extreme Brief justification, explanation, description: Thought Process
Work / School SELECT ONE: Regular Attendance Employed Seeking Employment Defies Authority Poor Performance Learning Disabilities Skips Class Absenteeism Disruptive Tardiness Illiterate Not Employed Suspended Expelled Dropped Out IEP/504 No Problem Slight Moderate Serious Severe Extreme justification, explanation, description: (Grade Level) Danger to Others Not Dangerous Causes Serious Injury Uses Weapons Assaultive Physically Aggressive Cruelty to Animals Violent Temper Sexually Aggressive Homicidal Threats Homicide Ideation Homicidal Attempt Accused/Sexual Assault No Problem Slight Moderate Serious Severe Extreme Brief justification, explanation, description: Anxiety Calm Tense Phobic Obsessive/Compulsive Anxious Worried/Fearful Panic Attacks Guilt Anti-Anxiety Meds No Problem Slight Moderate Serious Severe Extreme Brief justification, explanation, description: Thought Process
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