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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,
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[PDF File]TENANTS’ RIGHTS GUIDE - Attorney General of New York
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TENANTS’ RIGHTS GUIDE Office of the New York State Attorney General. The contract between a tenant and landlord, whether it is based on a written lease or a handshake, is one of the most common and important deals that are made across our state. It defines how renters will enjoy
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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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[DOC File]Aid Codes Master Chart (aid codes) - Medi-Cal
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Code Benefits SOC Program/Description K1 Full No California Work Opportunity and Responsibility to Kids (CalWORKs) – Single-Parent Safety Net and Drug/Fleeing Felon Family. ... 7F is valid for pregnancy test, initial visit, and services associated with the initial visit. ... Aid Codes Master Chart (aid …
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[PDF File]Patient Health Questionnaire (PHQ-9)
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PATIENT HEALTH QUESTIONNAIRE (PHQ-9) NAME: DATE: Over the last 2 weeks, how often have you been bothered by any of the following problems? Not at all Several days More than half the days Nearly every day (use " ü " to indicate your answer) 1. Little interest or pleasure in doing things 0 1 2 3
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[PDF File]Edinburgh Postnatal Depression Scale (EPDS)
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personality disorders. Women with postpartum depression need not feel alone. They may find useful information on the web sites of the National Women’s Health Information Center < www.4women.gov > and from groups such as Postpartum
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[PDF File]PTSD CheckList – Civilian Version (PCL-C)
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PTSD CheckList – Civilian Version (PCL-C) The PCL is a standardized self-report rating scale for PTSD comprising 17 items that correspond to
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[PDF File]Adverse Childhood Experience (ACE) Questionnaire Finding ...
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Adverse Childhood Experience (ACE) Questionnaire Finding your ACE Score ra hbr 10 24 06 While you were growing up, during your first 18 years of life: 1. Did a parent or other adult in the household often … Swear at you, insult you, put you down, or humiliate you?
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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
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[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.
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Personality test for kids printable