A mental health evaluation form is an especially outlined document which is executed for assessing the psychological level, ability of social behaviour and overall metal condition of an individual. These types of forms are generally used at hospital or by psychiatrists.
Sample Mental Health Evaluation Form:
Name of the individual: _____________
Date of birth: ___/___/ ____
Sex: ______________, Age: _________
Objective of this mental health evaluation form: ___________________
Is it the first mental health evaluation of the individual: _____________?
Is this individual suffering from any kind of mental disorder?
Any kind of head or brain injury survived by the individual: ___________
Is the candidate ingesting any psychological drugs? _________
Has this individual ever referred to some psychiatrist? ____________
Does the candidate undergo through frequent mood swings? _________
Rate the social behaviour of the individual: _______________________
Is the previous medical history of the candidate enclosed with this form?
Signature of the concerned Authority: __________