Angry Expressing Guilt Suspicious Anxious Hopeful Tearful Appropriate Being Irritable Having Trouble Concentrating Bright Labile Withdrawn Distressed Expressing Loss of Pleasure Expressing Worthlessness Fatigued Being Sad Expressing Worry Flat Difficult or Unable to Assess Suicidal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 Associations Tangential Egocentric Magical thinking Word Salad Test Results and Interpretation: (add as needed) Problem List: No HTN learning/cognitive impairment Prior TIA / stroke Cognitive impairment DM compliance difficulties Coronary heart disease Seizure disorder Lipids Hypertension Smoking history Compliance issues heart disease Diabetes mellitus Obesity Mood disorder smoking Hyperlipidemia Sedentary lifestyle Personality disorder mental illness Thought disorder Additional Comments: Diagnosis: Treatment Plan/Recommendations:
Angry Anxious Appropriate Bright Distressed Fatigued Flat Expressing Guilt Hopeful Being Irritable Labile Expressing Loss of Pleasure Being Sad Suspicious Tearful Having Trouble Concentrating Withdrawn Expressing Worthlessness Expressing Worry Difficult or Unable to Assess Suicidal Ideation/Intentions: Frequency of occurrence: How long does it last: Intensity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 Associations Magical thinking Neologisms Perseveration Rational Tangential Word Salad Test Results and Interpretation: (add as needed) Problem List: No HTN DM Lipids heart disease smoking mental illness learning/cognitive impairment compliance difficulties Hypertension Diabetes mellitus Hyperlipidemia Prior TIA / stroke Coronary heart disease Smoking history Obesity Sedentary lifestyle Cognitive impairment Seizure disorder Compliance issues Mood disorder Personality disorder Thought disorder Additional Comments: Diagnosis: Treatment Plan/Recommendations:
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