Initial Psych Consult

DATE OF CONSULTATION: [date name="variable_1" default=""]

C/C:
The patient was seen for initial behavioral health consultation in room [text name="variable_2" default=""]. Consultation was requested due to [text name="variable_3" default=""].

HPI:
[textarea name="variable_4" default="As per RN, "]
[textarea name="variable_5" default="As per BH, "]

DIAGNOSES/ASSESSMENT:
[select name="variable_88" value="|1.|2.|3.|4.|5.|6.|7.|8."] [select name="variable_61" value="|Major depressive disorder|Anxiety disorder|Generalized anxiety disorder|Bipolar disorder|Schizoaffective disorder|Schizophrenia|Schizophreniform disorder|Psychotic disorder|Delirium|Brief psychotic disorder|Tobacco use disorder|Alcohol use disorder|Drug use disorder|Cannabis use disorder|IDD/MR|Borderline personality disorder|Mood disorder|Methamphetamine abuse disorder|Heroin use disorder|Cocaine use disorder|Post-traumatic stress disorder|Nightmare disorder|Obsessive compulsive disorder|Impulse control disorder|Conversion disorder"] [select name="variable_62" value="|mild|moderate|severe"] [select name="variable_63" value="|single episode|recurrent"] [select name="variable_64" value="|depressed type|manic type|bipolar type|mixed type|unspecified type"] [text name="variable_65" default=""]
[select name="variable_89" value="|2.|3.|4.|5.|6.|7.|8."] [select name="variable_66" value="|Major depressive disorder|Anxiety disorder|Generalized anxiety disorder|Bipolar disorder|Schizoaffective disorder|Schizophrenia|Schizophreniform disorder|Psychotic disorder|Delirium|Brief psychotic disorder|Tobacco use disorder|Alcohol use disorder|Drug use disorder|Cannabis use disorder|IDD/MR|Borderline personality disorder|Mood disorder|Methamphetamine abuse disorder|Heroin use disorder|Cocaine use disorder|Post-traumatic stress disorder|Nightmare disorder|Obsessive compulsive disorder|Impulse control disorder|Conversion disorder"] [select name="variable_67" value="|mild|moderate|severe"] [select name="variable_68" value="|single episode|recurrent"] [select name="variable_69" value="|depressed type|manic type|bipolar type|mixed type|unspecified type"] [text name="variable_70" default=""]
[select name="variable_90" value="|3.|4.|5.|6.|7.|8."] [select name="variable_71" value="|Major depressive disorder|Anxiety disorder|Generalized anxiety disorder|Bipolar disorder|Schizoaffective disorder|Schizophrenia|Schizophreniform disorder|Psychotic disorder|Delirium|Brief psychotic disorder|Tobacco use disorder|Alcohol use disorder|Drug use disorder|Cannabis use disorder|IDD/MR|Borderline personality disorder|Mood disorder|Methamphetamine abuse disorder|Heroin use disorder|Cocaine use disorder|Post-traumatic stress disorder|Nightmare disorder|Obsessive compulsive disorder|Impulse control disorder|Conversion disorder"] [select name="variable_72" value="|mild|moderate|severe"] [select name="variable_73" value="|single episode|recurrent"] [select name="variable_74" value="|depressed type|manic type|bipolar type|mixed type|unspecified type"] [text name="variable_75" default=""]
[select name="variable_91" value="|4.|5.|6.|7.|8."] [select name="variable_77" value="|Major depressive disorder|Anxiety disorder|Generalized anxiety disorder|Bipolar disorder|Schizoaffective disorder|Schizophrenia|Schizophreniform disorder|Psychotic disorder|Delirium|Brief psychotic disorder|Tobacco use disorder|Alcohol use disorder|Drug use disorder|Cannabis use disorder|IDD/MR|Borderline personality disorder|Mood disorder|Methamphetamine abuse disorder|Heroin use disorder|Cocaine use disorder|Post-traumatic stress disorder|Nightmare disorder|Obsessive compulsive disorder|Impulse control disorder|Conversion disorder"] [select name="variable_78" value="|mild|moderate|severe"] [select name="variable_79" value="|single episode|recurrent"] [select name="variable_80" value="|depressed type|manic type|bipolar type|mixed type|unspecified type"] [text name="variable_81" default=""]
[select name="variable_92" value="|5.|6.|7.|8."] [select name="variable_82" value="|Major depressive disorder|Anxiety disorder|Generalized anxiety disorder|Bipolar disorder|Schizoaffective disorder|Schizophrenia|Schizophreniform disorder|Psychotic disorder|Delirium|Brief psychotic disorder|Tobacco use disorder|Alcohol use disorder|Drug use disorder|Cannabis use disorder|IDD/MR|Borderline personality disorder|Mood disorder|Methamphetamine abuse disorder|Heroin use disorder|Cocaine use disorder|Post-traumatic stress disorder|Nightmare disorder|Obsessive compulsive disorder|Impulse control disorder|Conversion disorder"] [select name="variable_83" value="|mild|moderate|severe"] [select name="variable_84" value="|single episode|recurrent"] [select name="variable_85" value="|depressed type|manic type|bipolar type|mixed type|unspecified type"] [text name="variable_86" default=""]
[select name="variable_101" value="|6.|7.|8."] [select name="variable_119" value="|Major depressive disorder|Anxiety disorder|Generalized anxiety disorder|Bipolar disorder|Schizoaffective disorder|Schizophrenia|Schizophreniform disorder|Psychotic disorder|Delirium|Brief psychotic disorder|Tobacco use disorder|Alcohol use disorder|Drug use disorder|Cannabis use disorder|IDD/MR|Borderline personality disorder|Mood disorder|Methamphetamine abuse disorder|Heroin use disorder|Cocaine use disorder|Post-traumatic stress disorder|Nightmare disorder|Obsessive compulsive disorder|Impulse control disorder|Conversion disorder"] [select name="variable_102" value="|mild|moderate|severe"] [select name="variable_103" value="|single episode|recurrent"] [select name="variable_104" value="|depressed type|manic type|bipolar type|mixed type|unspecified type"] [text name="variable_105" default=""]
[select name="variable_106" value="|7.|8."] [select name="variable_107" value="|Major depressive disorder|Anxiety disorder|Generalized anxiety disorder|Bipolar disorder|Schizoaffective disorder|Schizophrenia|Schizophreniform disorder|Psychotic disorder|Delirium|Brief psychotic disorder|Tobacco use disorder|Alcohol use disorder|Drug use disorder|Cannabis use disorder|IDD/MR|Borderline personality disorder|Mood disorder|Methamphetamine abuse disorder|Heroin use disorder|Cocaine use disorder|Post-traumatic stress disorder|Nightmare disorder|Obsessive compulsive disorder|Impulse control disorder|Conversion disorder"] [select name="variable_108" value="|mild|moderate|severe"] [select name="variable_109" value="|single episode|recurrent"] [select name="variable_110" value="|depressed type|manic type|bipolar type|mixed type|unspecified type"] [text name="variable_111" default=""]
[select name="variable_112" value="|8."] [select name="variable_113" value="|Major depressive disorder|Anxiety disorder|Generalized anxiety disorder|Bipolar disorder|Schizoaffective disorder|Schizophrenia|Schizophreniform disorder|Psychotic disorder|Delirium|Brief psychotic disorder|Tobacco use disorder|Alcohol use disorder|Drug use disorder|Cannabis use disorder|IDD/MR|Borderline personality disorder|Mood disorder|Methamphetamine abuse disorder|Heroin use disorder|Cocaine use disorder|Post-traumatic stress disorder|Nightmare disorder|Obsessive compulsive disorder|Impulse control disorder|Conversion disorder"] [select name="variable_114" value="|mild|moderate|severe"] [select name="variable_115" value="|single episode|recurrent"] [select name="variable_116" value="|depressed type|manic type|bipolar type|mixed type|unspecified type"] [text name="variable_117" default=""]
[textarea name="variable_118" default=""]

PLAN:
[textarea name="variable_55" default=""]

ATTENDING PHYSICIAN'S NOTES/COMMENTS:
[textarea name="variable_56" default=""]