As you go through the following series of questions, please do your best to answer them in complete sentences offering as much detail as you can. While this is time consuming, the extra detail will help us better understand you and your background.
History with CPS
Mental Health History
Current Mental Health Symptoms
Below is a list of symptoms. Check any that you have experienced recently.
(In the last month or two.)
Social History (Marital/Relationships)
Employment and Educational History
What are your four most important personal/social/work goals
(Include goals relating to your children, family relationships, working/vocational retraining, health, social activities, sports/hobbies, etc.)
The information I have provided in this questionnaire is true and accurate to the best of my knowledge and recollection.