The document contains an intake and evaluation form for a patient seeking mental health services, which collects information on the patient's personal details, medical history, current functioning including mood, thought processes, suicidal ideation, diagnoses, and recommended treatment plan. Psychological evaluation procedures are noted, along with factors assessed like orientation, appearance, and insight. A problem list is included along with space for comments on the patient's case.

1. Georgia Mental Health Intake & Evaluation Form
Patient Name: Click here to enter text.
Medical Record #: Click here to enter text.
Date of Birth: select month select day select year
Current Age: Click here to enter text.
Principal Spoken Language: Click here to enter text.
Date Service Provided: Click here to enter a date.
Primary Care Provider: Click here to enter text.
Reason for Referral:
Service(s) Provided: select an option
Evaluation Procedures:
☐Interview with
select an option
☐Review of records
☐Psychological testing: select an option

2. Click here to enter text.
Background Information
Medical History:
☐see medical chart for details
☐addiction
☐cardiac illness
☐hypertension
☐diabetes
☐sleep disorder
☐fertility issues
☐per patient history is significant for chronic pain
☐nutrition/obesity/eating disorder
☐other
Additional Comments:
Current Medications per patient: Click here to enter text.
Current Functioning
Orientation: select an option
Appearance/Personal Hygiene: select an option
Eye Contact: select an option
Psychosis: select an option

3. Hallucinations: ☐None ☐Auditory ☐visual ☐olfactory
☐gustatory
Delusions: ☐Bizarre ☐Grandiose ☐Jealousy ☐Nihilistic
☐Persecutory ☐Reference ☐Somatic
Homicidal Ideation/Intentions: select an option
☐
Duty to Protect process completed
Insight: select an option
Intelligence: select an option
Memory/Cognition: select an option
Mood/Affect:
☐Angry
☐Anxious
☐Appropriate
☐Bright
☐Distressed
☐Fatigued
☐Flat
☐Expressing Guilt
☐Hopeful
☐Being Irritable
☐Labile
☐Expressing Loss of Pleasure

4. ☐Being Sad
☐Suspicious
☐Tearful
☐Having Trouble Concentrating
☐Withdrawn
☐Expressing Worthlessness
☐Expressing Worry
☐Difficult or Unable to Assess
Suicidal Ideation/Intentions: select an option
Frequency of occurrence: Click here to enter text.
How long does it last: Click here to enter text.
Intensity of suicidal thoughts: Click here to enter text.
Reasons individual would rather die than live: Click here to
enter text.
Detailed Plan: select an option
Plan location: Click here to enter text.
How lethal is the method: Click here to enter text.
Access to lethal methods: Click here to enter text.
If firearms, are they being removed from patient access:
select an option
Steps taken to enact plan: select an option
Rehearsal behaviors: Click here to enter text.
Obtained access: Click here to enter text.
Details: Click here to enter text.
Thought Process:
☐Blocking
☐Circumstantial
☐Clang Associations
☐Coherent
☐Egocentric

5. ☐Evasive
☐Flight of ideas
☐Incoherent, Logical
☐Loose Associations
☐Magical thinking
☐Neologisms
☐Perseveration
☐Rational
☐Tangential
☐Word Salad
Test Results and Interpretation:
(add as needed)
Problem List:
☐No HTN
☐DM
☐Lipids
☐heart disease
☐smoking
☐mental illness
☐learning/cognitive impairment
☐compliance difficulties
☐Hypertension
☐Diabetes mellitus
☐Hyperlipidemia
☐Prior TIA / stroke
☐Coronary heart disease
☐Smoking history
☐Obesity
☐Sedentary lifestyle

6. ☐Cognitive impairment
☐Seizure disorder
☐Compliance issues
☐Mood disorder
☐Personality disorder
☐Thought disorder
Additional Comments:
Diagnosis: select an option select an option
select an option select an option
select an option select an option
select an option select an option
select an option select an option
select an option select an option
Treatment Plan/Recommendations:
Type you name here as a signature
Click here to enter a date.
Insert Clinician’s Name Here
Date
1
3

7. image1.png
PowerPoint_3F_Advertising_Report_Instructions.docx
Grader - Instructions PPT 2019
ProjectPowerPoint_3F_Advertising_Report
Project Description:
In the following project, you will format several of the slides in
a presentation that the City Manager is developing for an
upcoming City Council meeting.
Steps to Perform:
Step
Instructions
Points Possible
1
Open the file named
Student_PowerPoint_3F_Advertising_Report.pptx downloaded
with this project.
0
2
On Slide 3, in the content placeholder, insert a Line with
Markers chart. In the worksheet, in the first row, enter the
following data:
In row 1, beginning in cell B1:
2020,
2021,
2022
In row 2, beginning in cell A2:
18-30,
12,
10,
11
In row 3, beginning in cell A3:

8. 31-45,
40,
45,
38
In row 4, beginning in cell A4:
46-55,
16,
19,
26
In row 5, beginning in cell A5:
56+,
32,
26,
25
10
3
Apply Chart Style 6, and then apply the Wipe entrance
animation to the chart.
10
4
Change the Chart Title to
(Percentages)
10
5
On Slide 4, in the content placeholder, insert a Table with 2
columns and 4
rows.
In the first row, enter
Demographic in the first cell and
Description in the second cell.
In the second row, enter
Gender in the first cell and
65% Female in the second cell.
In the third row, enter
Median Household Income in the first cell
and

9. $87,200 in the second cell.
In the fourth row, enter
Education in the first cell and
46.9% hold a college degree in the second
cell.
10
6
Change the height of the table to
4.77". Align the table text so that it is
centered horizontally and vertically within the cells and then
change the Font Size of all of the text in the table to 24.
10
7
Apply table style Medium Style 3 - Accent 2, and then apply a
Round Bevel effect to the first row.
Note, depending on the version of Office used, the bevel effect
may be named Circle.
10
8
On Slide 5, in the content placeholder, insert a Clustered
Column chart. In the worksheet, enter the following data:
In row 1, beginning in cell B1:
2020,
2021,
2022
In row 2, beginning in cell A2:
Quarter 1,
182534,
165823,
201653
In row 3, beginning in cell A3:
Quarter 2,
175746,

10. 195920,
197812
In row 4, beginning in cell A4:
Quarter 3,
195042,
203465,
189767
In row 5, beginning in cell A5:
Quarter 4,
201586,
221860,
245873
10
9
Apply Chart Style 8 to the chart, and then remove the Chart
Title element.
10
10
Apply the Wipe entrance animation to the chart. Change the
Effect Options so that the animation is applied By Series.
10
11
Change the chart animation Timing so that the animation starts
After Previous.
8
12
Insert a Header & Footer on the Notes and Handouts. Include
the Date and time updated automatically, the Page number, and
a Footer with the text
3F_Advertising_Report Display the
document properties. As the Tags, type
advertising report
2
13
Save and close the file, and then submit for grading.
0

11. Total Points
100
Created On: 07/11/2019 1
GO19_PP_CH03_GRADER_3F_AS - Advertising Report
1.0
Ishfaq_PowerPoint_3F_Advertising_Report.pptx
Open Home Media Group
The Backyard View
Advertising Overview
The Backyard View is targeted at home owners with an interest
in outdoor living and improving their property’s value.
Three-Year Viewer Analysis
Audience Demographics
Advertising Revenue by Quarter
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16. Dashboard
COUN-6360D-6/COUN-6324S-6/COUN-6360-6
(11/28/2022-02/05/2023)-PT41
Week 3: Learning Resources
Skip To Content
Dashboard

17. Account
Dashboard
Courses

18. Calendar
Inbox
History
My Media

19. Charlotte
Help
Close