Dimension Note ASAM

Dimension 1:
[text name="variable_1" default="sample text"] reports current Paws sx as: [textarea name="variable_1" default="sample text"]
[text name="variable_1" default="sample text"] reports their cravings rated at: [textarea name="variable_2" default="sample text"]
[text name="variable_1" default="sample text"] stated: [textarea name="variable_3" default="sample text"]
[text name="variable_1" default="sample text"] reports experiencing anxiety and depression as rated: [textarea name="variable_4" default="sample text"]
[text name="variable_1" default="sample text"] reports concerns related to sleeping are: [textarea name="variable_5" default="sample text"]
[text name="variable_1" default="sample text"] stated in regards to mood and sleep: [textarea name="variable_6" default="sample text"]
[text name="variable_1" default="sample text"] reports urges, triggers, using dreams as: [textarea name="variable_7" default="sample text"]
[text name="variable_1" default="sample text"] feels: [textarea name="variable_8" default="sample text"] about these triggers
[text name="variable_1" default="sample text"] was able to identify the following triggers: [textarea name="variable_9" default="sample text"]
[text name="variable_1" default="sample text"] states: [textarea name="variable_10" default="sample text"]




Dimension 2:
[text name="variable_1" default="sample text"] reports their overall health as: [textarea name="variable_11" default="sample text"]
[text name="variable_1" default="sample text"] reports health concerns include: [textarea name="variable_12" default="sample text"]
[text name="variable_1" default="sample text"]states: [textarea name="variable_13" default="sample text"]
[text name="variable_1" default="sample text"] has been noted to eat:[text name="variable_2" default="sample text"] Meals a day
[text name="variable_1" default="sample text"] reports the following biomedical sx: [textarea name="variable_14" default="sample text"]
Medication updates: [textarea name="variable_15" default="sample text"]
[text name="variable_1" default="sample text"] reports: [textarea name="variable_16" default="sample text"]




Dimension 3:
[text name="variable_1" default="sample text"] denies any SI, SIB, or HI at this time
[text name="variable_1" default="sample text"] reports that in regards to their mental health they are addressing: [textarea name="variable_17" default="sample text"]
[text name="variable_1" default="sample text"] reports: [textarea name="variable_18" default="sample text"]
[text name="variable_1" default="sample text"] has been working to take steps towards recovery aeb: [textarea name="variable_19" default="sample text"]
[text name="variable_1" default="sample text"] has been struggling to make progress aeb: [textarea name="variable_20" default="sample text"]




Dimension 4
[text name="variable_1" default="sample text"] has been attending 12 step meetings and programming with RCA Treatment
[text name="variable_1" default="sample text"] reports they are currently working on : [textarea name="variable_21" default="sample text"]
[text name="variable_1" default="sample text"] reports during groups: [textarea name="variable_22" default="sample text"]
[text name="variable_1" default="sample text"] is in the stage of change of: [textarea name="variable_23" default="sample text"]
[text name="variable_1" default="sample text"] reports regarding their change: [textarea name="variable_24" default="sample text"]
[text name="variable_1" default="sample text"] has identified coping strategies learned in treatment as: [textarea name="variable_25" default="sample text"]
[text name="variable_1" default="sample text"] reports: [textarea name="variable_26" default="sample text"]
[text name="variable_1" default="sample text"] identified recreational activities and healthy hobbies as: [textarea name="variable_27" default="sample text"]
[text name="variable_1" default="sample text"] reports willingness to continue with tx and programming: [textarea name="variable_28" default="sample text"]




Dimension 5:
[text name="variable_1" default="sample text"] reports that if they left treatment they would: [textarea name="variable_29" default="sample text"]
[text name="variable_1" default="sample text"] main concerns in relapse [textarea name="variable_30" default="sample text"]
[text name="variable_1" default="sample text"]'s' reported protective factors are: [textarea name="variable_31" default="sample text"]
[text name="variable_1" default="sample text"] reports: [textarea name="variable_32" default="sample text"]
[text name="variable_1" default="sample text"] perception of social, family, and skills support [textarea name="variable_33" default="sample text"]
[text name="variable_1" default="sample text"] has identified triggers and been finding ways to cope with them aeb: [textarea name="variable_34" default="sample text"]




Dimension 6:
[text name="variable_1" default="sample text"] has addressed continuing care with clinical and case management team.
[text name="variable_1" default="sample text"]'s' staff is aware of their concerns.
[text name="variable_1" default="sample text"] support plan is: [textarea name="variable_35" default="sample text"]
[text name="variable_1" default="sample text"] family support plan is: [textarea name="variable_36" default="sample text"]
[text name="variable_1" default="sample text"] reports wanting the following aftercare: [textarea name="variable_37" default="sample text"]
[text name="variable_1" default="sample text"] reports: [textarea name="variable_38" default="sample text"]
Dimension 1:
reports current Paws sx as:

reports their cravings rated at:

stated:

reports experiencing anxiety and depression as rated:

reports concerns related to sleeping are:

stated in regards to mood and sleep:

reports urges, triggers, using dreams as:

feels:
about these triggers
was able to identify the following triggers:

states:





Dimension 2:
reports their overall health as:

reports health concerns include:

states:

has been noted to eat: Meals a day
reports the following biomedical sx:

Medication updates:

reports:





Dimension 3:
denies any SI, SIB, or HI at this time
reports that in regards to their mental health they are addressing:

reports:

has been working to take steps towards recovery aeb:

has been struggling to make progress aeb:





Dimension 4
has been attending 12 step meetings and programming with RCA Treatment
reports they are currently working on :

reports during groups:

is in the stage of change of:

reports regarding their change:

has identified coping strategies learned in treatment as:

reports:

identified recreational activities and healthy hobbies as:

reports willingness to continue with tx and programming:





Dimension 5:
reports that if they left treatment they would:

main concerns in relapse

's' reported protective factors are:

reports:

perception of social, family, and skills support

has identified triggers and been finding ways to cope with them aeb:





Dimension 6:
has addressed continuing care with clinical and case management team.
's' staff is aware of their concerns.
support plan is:

family support plan is:

reports wanting the following aftercare:

reports:

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 0, 81 form elements, 239 boilerplate words, 43 text boxes, 38 text areas, 81 total clicks
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