CURRENT MENTAL HEALTH SYMPTOMS

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

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 and 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:"].

PREFERRED GENDER:
CURRENT MENTAL HEALTH SYMPTOMS

Mood:
Client described current mood as "."

Depression:
.


Anhedonia:
.


Anxiety:
.


Appetite:
.


Sleep:
.


Client reported averaging the total of hours of sleep each night.

Level of Energy:
.


Hopelessness/Worthlessness:
.

Concentration/Attention:
.


Trauma-and Stress-Related symptoms:
.

Psychotic symptoms:
.

Suicidal or Homicidal Ideation:
.

Self-harming behaviors:
.

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0.59, 34 form elements, 46 boilerplate words, 2 text boxes, 7 text areas, 13 drop downs, 12 conditionals, 22 total clicks
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