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[DOC File]LEAVE REQUEST FORM/AUTHORIZATION - United States Navy
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navcompt form 3065 (3pt) (rev. 2-83) 1. date of request. 2. for . admin. use only. approval of this leave is . not valid . without control no,
[PDF File]The Mood Disorder Questionnaire (MDQ) - Overview
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The Mood Disorder Questionnaire (MDQ) - Overview The Mood Disorder Questionnaire (MDQ) was developed by a team of psychiatrists, researchers and consumer advocates to address the need for timely and accurate evaluation
[PDF File]Sport concussion assessment tool - 5th edition
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Does the athlete report that their neck is pain free at rest? Y N If there is NO neck pain at rest, does the athlete have a full range of ACTIVE pain free movement? Y N Is the limb strength and sensation normal? Y N In a patient who is not lucid or fully conscious, a cervical spine injury should be assumed until proven otherwise. RED FLAGS:
[PDF File]NAME : MONTREAL COGNITIVE ASSESSMENT (MOCA) …
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POINTS TOTAL MEMORY NAMING VISUOSPATIAL / EXECUTIVE ATTENTION LANGUAGE ABSTRACTION DELAYED RECALL ORIENTATION Read list of words, subject must repeat them.
[PDF File]ASSESSMENT Timed Up & Go (TUG) - Centers for Disease ...
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ASSESSMENT Purpose: To assess mobility Equipment: A stopwatch Directions: Patients wear their regular footwear and can use a walking aid, if needed. Begin by having the patient sit back in a standard arm chair and identify a line 3 meters, or 10 feet away, on the floor. 2 On the word “Go,” begin timing. 3 Stop timing after patient sits back ...
[PDF File]COLUMBIA-SUICIDE SEVERITY RATING SCALE (C-SSRS)
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Columbia-Suicide Severity Rating Scale (C-SSRS) The Columbia-Suicide Severity Rating Scale (C-SSRS) is a questionnaire used for suicide assessment developed by multiple institutions, including Columbia University, with NIMH support. The scale is
[PDF File]Edinburgh Postnatal Depression Scale (EPDS)
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Users may reproduce the scale without further permission, providing they respect copyright by quoting the names of the authors, the title, and the s ource of the paper in all reproduced copies. Instructions for using the Edinburgh Postnatal Depression Scale: 1.
[PDF File]Clinical Opiate Withdrawl Scale - National Institute on ...
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Clinical Opiate Withdrawal Scale Introduction The Clinical Opiate Withdrawal Scale (COWS) is an 11-item scale designed to be administered by a clinician. This tool can be used in both inpatient and outpatient settings to reproducibly rate common signs and symptoms of opiate withdrawal and monitor these symptoms over time. The summed
[PDF File]Patient Health Questionnaire (PHQ-9)
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PHQ-9 Patient Depression Questionnaire For initial diagnosis: 1. Patient completes PHQ-9 Quick Depression Assessment. 2. If there are at least 4 3s in the shaded section (including Questions #1 and #2), consider a depressive
Nutritional Information & Facts Download | Zaxby's
Zaxby’s cannot guarantee our foods are 100% allergen free. We use shared equipment during food preparation which could result in the cross-contact of allergens. Additionally,
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