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[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
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[PDF File]An IRS individual taxpayer identification number (ITIN) is ...
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Form W-7 (Rev. September 2016) Department of the Treasury Internal Revenue Service . Application for IRS Individual Taxpayer Identification Number
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[PDF File]REQUEST FOR VERIFICATION CASE NAME: CASE NUMBER
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REQUEST FOR VERIFICATION CALIFORNIA DEPARTMENT OF SOCIAL SERVICES You have asked for CalWORKs (CW) CalFresh (CF) Medi-Cal (MC) We need proof from you to see if you can get (or keep getting) cash aid or other benefits. We have listed the information we need below.
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[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 of bipolar disorder. Clinical Utility n The MDQ is a brief self-report instrument that takes about 5 minutes to complete.
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[PDF File]2018 Form 8867
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A. Interview the taxpayer, ask adequate questions, document the taxpayer’s responses on the return or in your notes, review adequate information to determine if the taxpayer is eligible to claim the credit(s) and/or HOH filing status and to determine the amount of the credit(s) claimed;
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[PDF File]Application for Social Security Card
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Form SS-5 (08-2011) ef (08-2011) Destroy Prior Editions. Page 1. Application for a Social Security Card. Applying for a Social Security Card is . free! USE THIS APPLICATION TO: Apply for …
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[PDF File]PHQ-9* Questionnaire for Depression Scoring and ...
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PHQ-9* Questionnaire for Depression Scoring and Interpretation Guide For physician use only Scoring: Count the number (#) of boxes checked in a column. Multiply that number by the value indicated below, then add the subtotal to produce a total score. The possible range is 0-27. Use the table below to interpret the PHQ-9 score.
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[PDF File]Form I-693, Report of Medical Examination and Vaccination ...
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Form I-693 07/15/19. Page 1 of 14. Report of Medical Examination and Vaccination Record . Department of Homeland Security . U.S. Citizenship and Immigration Services
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[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 evidence-supported and is part of a national and international public health initiative involving the
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[PDF File]NICHQ Vanderbilt Assessment Scale—PARENT Informant
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Symptoms (continued) Never Occasionally Often Very Often 33. Deliberately destroys others’ property 0 1 2 3 34. Has used a weapon that can cause serious harm (bat ...
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Interview template for kids