Pre-appointment check-in with Dr Al Griskaitis
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First name *
Last name *
What's the best phone number for phone review?
How are things going? *
Terrible
Terrific
Have you undertaken the recommendations made by Dr Al on your last meeting? *
PHQ-9 : In the past 2 weeks how often have you been affected by the following problems? *
Not at all
Several days
More than half the time
Nearly every day
Trouble falling asleep, staying asleep or oversleeping?
Feeling tired or having little energy?
Trouble concentrating on things like reading or TV?
Moving or speaking slowly or feeling fidgety / restless?
Poor appetite or overeating?
Feeling bad about yourself, feeling like a failure or that you've let down yourself or your family?
Feeling down or Depressed?
Little interest or pleasure in doing things
Thinking you'd be better of dead or that you want to hurt yourself in some way?
Do you require any medication scripts, certificates or paperwork? If so, what do you require? *
In the last 7 days have you... *
Yes
No
...had episodes of overwhelming emotional Distress
...used alcohol, drug or a sedative to alleviate distress?
...alcohol or a sedative to sleep?
...had gut symptoms (e.g. gas/bloating/loose stools)
...felt physically unwell
...undertaken regular exercise?
...undertaken mindfulness or meditation?
About how many ALCOHOL containing DRINKS do you think you've drunk in the last 7 DAYS? *
Since we last saw each other have you... *
Yes
No
...seen a psychologist?
...seen your GP?
...seen a specialist doctor?
...utilised skills to manage stress/Distress?
...watched/visited PSYCHcollective.com?
...undertaken psychology program?
Who is your usual GP? *
Who is your usual psychologist?
If you take medications, which are you currently taking? *
Take a new line for each medications
Current psychology program?
(If undertaken), this might be a Hospital Day Program (eg. Dealing with Distress) or a online program (eg Anxiety ThisWayUp)
If you take regular medications, have you had any... *
Yes
No
Not applicable
...recent changes to medications?
...side effects to medications?
...feeling they should be altered?
Lastly, Dr AL will look at this just prior to your appointment. Is there anything else you wish to add?
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