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[PDF File]The Mood Disorder Questionnaire (MDQ) - Overview
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4. Hirschfeld RMA, et al. Screening for bipolar disorder in patients treated for depression in a family medicine clinic. JABFP 2005, 18: 233-239. STABLE RESOURCE TOOLKIT. Please answer each question to the best of your ability 1. Has there ever been a …
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[DOT File]ocfs.ny.gov
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A registered nurse is NOT authorized to sign the Medical Status section but CAN sign the TB Test Information. A health care professional may use an equivalent form as long as the information on this form is included. See additional instructions about the tuberculin test …
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[PDF File]FMCSA Medical Examiner Handbook
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Introduction This handbook provides information and guidance to the medical examiner who performs the commercial driver medical examination. Determining driver medical fitness for duty is a …
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[PDF File]APPLICATION FOR TEXAS DRIVER LICENSE OR …
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DRIVER LICENSE APPLICANTS: Answers to 1 through 7 below are for the confidential use of the Department. YES NO MEDICAL HISTORY QUESTIONS 1. Do you currently have or have you ever been diagnosed with or treated for any medical condition that may affect your ability to safely
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[DOC File]LEAVE REQUEST FORM/AUTHORIZATION - United States Navy
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4. Block 16 requires the following information: Normal working hours for day of departure. Normal working hours for day of return. If day of departure is not a workday, enter “NONE” 5. Information required in blocks 17 and 18 may be obtained from Block 59 of your latest Leave and Earnings-Statement or …
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[PDF File]Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist ...
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suffer from it.1-4 Because this disorder is often misunderstood, many people who have it do not receive appropriate treatment and, as a result, may never reach their full potential. Part of the problem is that it can be difficult to diagnose, particularly in adults. The Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist was developed
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[PDF File]“A Rose for Emily” by William Faulkner (1930) I
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“A Rose for Emily” by William Faulkner (1930) I WHEN Miss Emily Grierson died, our whole town went to her funeral: the men through a sort of respectful affection for a fallen monument, the women mostly out of curiosity to see the inside of her house, which no one save an old man-servant--a combined gardener and cook--had seen
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[PDF File]NAME : MONTREAL COGNITIVE ASSESSMENT (MOCA) …
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Subject has to repeat them in the backward order [ ] 7 4 2 Read list of letters. The subject must tap with his hand at each letter A. No points if ≥ 2 errors [ ] FBACMNAAJKLBAFAKDEAAAJAMOFAAB Serial 7 subtraction starting at 100 [ ] 93 [ ] 86 [ ] 79 [ ] 72 [ ] 65 Repeat : …
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[PDF File]Epworth Sleepiness Scale
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Epworth Sleepiness Scale Name: _____ Today’s date: _____ Your age (Yrs): _____ Your sex (Male = M, Female = F): _____ How likely are you to doze off or fall asleep in the following situations, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you haven’t done some of these things recently try ...
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4 color personality test printable