One word to describe yourself
[PDF File]COLUMBIA-SUICIDE SEVERITY RATING SCALE (C-SSRS)
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General non-specific thoughts of wanting to end one’s life/commit suicide (e.g., “I’ve thought about killing myself”) without thoughts of ways to kill oneself/associated methods, intent, or plan during the assessment period. Have you actually had any thoughts of killing yourself? If yes, describe: Yes No Yes No 3.
[PDF File]Edinburgh Postnatal Depression Scale (EPDS)
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Edinburgh Postnatal Depression Scale 1 (EPDS) Postpartum depression is the most common complication of childbearing. 2 The 10-question Edinburgh
[PDF File]Workers’ Compensation Claim Form (DWC 1) & Notice of ...
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your injury by filing a claim form. Describe your injury completely. Include every part of your body affected by the injury. If you mail the form to your employer, use first-class or certified mail. If you buy a return receipt, you will be able to prove that the claim form was mailed and when it was delivered. Within one
[PDF File]2018 Form 8889
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Form 8889 (2018) Page . 2 Part III Income and Additional Tax for Failure To Maintain HDHP Coverage. See the instructions before completing this part.
[PDF File]Patient Health Questionnaire (PHQ-9)
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- if there are at least 5 3s in the shaded section (one of which corresponds to Question #1 or #2) Consider Other Depressive Disorder - if there are 2-4 3s in the shaded section (one of which corresponds to Question #1 or #2) Note: Since the questionnaire relies on patient self-report, all responses should be verified by the clinician,
[PDF File]Report of Motor Vehicle Accident
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Circle one of the 9 diagrams (numbered 0-8) if it ... MV-104 (5/11) PAGE 2 of 2 . SECTION A . You must report within 10 days any accident . ... Check all column(s) that apply and DESCRIBE INJURIES: A -Severe lacerations, broken or distorted limbs, skull fracture, crushed chest, internal
[PDF File]Performance Appraisal Plan Examples - USDA
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performance plan that focus on results achieved, contain at least one element that is aligned with organizational goals, and are in place within 30 calendar days of the beginning of the appraisal period. Mid year reviews are conducted timely and according to Agency guidelines. Ratings are accurate and issued within 30 calendar days of
[PDF File]Internal Revenue Service Department of the Treasury
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certified to the Marketplace would be in your tax family (yourself, spouse, and dependents) when you enrolled in a qualified health plan. If this information changed during 2018 and you did not promptly report it to the Marketplace, the amount of APTC paid may be substantially different from the amount of PTC you can take on your tax return.
[PDF File]Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist ...
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Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist Please answer the questions below, rating yourself on each of the criteria shown using the scale on the right side of the page. As you answer each question, place an X in the box that best describes how you have felt and conducted yourself over the past 6 months. Please give
[PDF File]FL-150 INCOME AND EXPENSE DECLARATION
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(If you have more than one job, attach an 8 1/2-by-11-inch sheet of paper and list the same information as above for your other jobs. Write "Question 1—Other Jobs" at the top.) ... (If you're not sure about percentage or it has not been agreed on, please describe your parenting schedule here.) 17. Children's health-care expenses
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