CURRENT MENTAL HEALTH SYMPTOMS 8.31.23
PREFERRED GENDER:[select name="gender" value="Male|Female|Trans"][conditional field="gender" condition="(gender).is('Male')"]he[/conditional][conditional field="gender" condition="(gender).is('Female')"]she[/conditional][conditional field="gender" condition="(gender).is('Trans')"]they[/conditional][conditional field="gender" condition="(gender).is('Male')"]his[/conditional][conditional field="gender" condition="(gender).is('Female')"]her[/conditional][conditional field="gender" condition="(gender).is('Trans')"]their [/conditional][conditional field="gender" condition="(gender).is('Male')"]him[/conditional][conditional field="gender" condition="(gender).is('Female')"]hers[/conditional][conditional field="gender" condition="(gender).is('Trans')"]them[/conditional] CURRENT MENTAL HEALTH SYMPTOMS CURRENT MENTAL HEALTH SYMPTOMS: Mood: Client described [conditional field="gender" condition="(gender).is('Male')"]his[/conditional][conditional field="gender" condition="(gender).is('Female')"]her[/conditional] [conditional field="gender" condition="(gender).is('Trans')"]their[/conditional]current mood as "[text name="mood" default=""]." Depression: [select name="Dependorse" value="Client denied currently experiencing any symptoms of depression|Client endorsed currently experiencing symptoms of depression. These were described as"]. [textarea name="depsymp" default=""] Anhedonia: [select name="Anhedoniaendorse" value="Client denied currently experiencing any loss of interest in enjoyable or pleasurable activities|Client endorsed currently experiencing a loss of interest/pleasure in"]. [textarea name="anhe" default=""] Anxiety: [select name="Anxietyendorse" value="Client denied currently experiencing any symptoms of anxiety|Client endorsed currently experiencing symptoms of anxiety. These were described as ... "]. [textarea name="endorseanxsymp" default=""] Appetite: [select name=Appetiteendorse" value="Client denied changes in appetite|Client endorsed a decrease in appetite|Client endorsed an increase in appetite"]. [textarea name="endapp" default=""] Sleep: [select name="Sleepeendorse" value="Client denied any changes in sleep|Client endorsed difficulty falling asleep|Client endorsed trouble staying asleep|Client endorsed waking too early|Client endorsed sleeping too much"]. [textarea name="endsleep" default=""] Client reported averaging the total of [text name="sleephous" default=""] hours of sleep each night. Level of Energy: [select name="Energyendorse" value="Client denied changes in energy|Client endorsed feeling tired|Client endorsed having little energy"]. [textarea name="endenerg" default=""] Hopelessness/Worthlessness: [select name="Hopeendorse" value="Client denied any feelings of worthlessness|Client endorsed feelings of worthlessness|Client endorsed feelings of hopelessness"]. Concentration/Attention: [select name="concentendorse" value="Client denied any changes in concentration or attention|Client endorsed difficulty with concentration"]. [textarea name="endcontatt" default=""] Trauma-and Stress-Related symptoms: [select name="traumaendorse" value="Client denied any exposure to a traumatic or stressful event. Client denied experiencing any trauma and stress related symptoms| Client endorsed exposure to a traumatic/stressful event"]. Psychotic symptoms: [select name="psychoendorse" value="Client denied experiencing any current psychotic symptoms (i.e., hallucinations, delusions)|Client endorsed currently experiencing |the following symptoms:"]. Suicidal or Homicidal Ideation: [select name="suicideaendorse" value="Client denied any current thoughts of harm to self or others|Client endorsed passive thoughts of death without plan|Client endorsed thoughts of suicide with plan"]. Self-harming behaviors: [select name="harmeaendorse" value="Client denied engaging in current self-harming behaviors (i.e., cutting, burning)|Client endorsed engaging in current self-harming behaviors. These behaviors include:"]. Access to firearms: [select name="firearms" value="Client denied having access or owning any firearms|Client endorsed owning a firearm"].
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Sandbox Metrics: Structured Data Index 0.61, 35 form elements, 53 boilerplate words, 2 text boxes, 7 text areas, 14 drop downs, 12 conditionals, 23 total clicks
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