MENTAL HEALTH HISTORY

MENTAL HEALTH HISTORY
Family Mental Health History:
[select name="famhist" value="Client denied family history of mental health concerns or attempted suicide| Client endorsed family history of mental health concerns. Client shared"][text name="familyhis" default="sample text""].

Past Suicide Attempts:
[select name="pastsuic" value="Client denied any history of suicidal ideation or attempted suicide|Client endorsed history of attempted suicide. Client shared"][text name="pastattempt" default="sample text""].

Psychiatric Hospitalizations:
[select name="pasthosp" value="Client denied any past psychiatric hospitalizations|Client endorsed hospitalization for a previous psychiatric concern(s). Client reported"][text name="pasthosp" default="sample text""].

Past Psychiatric Medications
[select name="pastmeds" value="Client denied any past use of psychiatric medications|Client reported previous use of the following psychiatric medication(s):"] [select name="pastmedlist" value="|fluoxetine (Prozac)|sertraline (Zoloft)|escitalopram (Lexapro)|citalopram (Celexa)|Vilazodone (Viibryd)|Aripiprazole (Abilify)|Duloxetine Cymbalta)"][text name="andpastmed" default="sample text""].

Past Psychotherapy: 
[select name="pastpsych" value="Client denied any past mental health treatment or psychotherapy| Client endorsed receiving previous psychotherapy from"] [text name="pastpsych" default="sample text""].