Mental And Behavioral Health
School Evaluation
Database Demo
This assessment is to improve and assist a school system in better determination of a mental plan for a child with the knowledge of a presenting diagnosis and recommendation as it relates to their mental health. It is not considered a full comprehensive psychiatric assessment of a child which would require a detailed comprehensive interview with the child and their caretakers.
This assessment only assesses a history of 90 days
Basic Information
| Date of evaluation | |||
| Name | Client ID | ||
| Address | Contact Number | ||
| Grade | Level of education | ||
| Guardian | Participants | ||
| DOB | Age: | Referal By: | |
| Gender |
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Community Agency Involved |
Chief Complaint and presenting issues:
| Questions | Responses |
|---|---|
| 1. What is reason or rationale for your presentation here and now: |
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| 2. Desribe the circumstances and what you think led to the need for this mental health evaluation. |
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| 3. Identify behaviors specific for the reason for this assessment. |
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| 4. What are the current behaviors being displayed that is disturbing a normal school session. What school official is reporting this. |
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