Directions: Of the following symptoms, select the ones you find you have been struggling with most in the past six (6) months to a degree that is inconsistent with your developmental level and that negatively impacts directly on your social, academic, and/or occupational activities.
Directions: In the next section, please answer “Yes” or “No” to the best of your recollection in order to better understand how the endorsed symptoms above have affected you throughout your life.
Directions: In this last section, please answer the following questions in order to better understand how the endorsed symptoms above have affected you throughout your life.
This instrument was created by Bryant Prieto, MS, LPC, owner of New Leaf Counseling of the River Valley, Inc. for use by its provider, as well as Dr. Monty Atchley who is affiliated with Stonehaven Behavioral Health & Wellness.
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