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No action needed
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Needs action but not immediate
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Needs immediate action
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How does your family get along with each other?
Optional probes: Child Protection Issues, Family Violence |
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Care provider's notes
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How is your school attendance? How are your grades? |
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Care provider's notes
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What are your relationships like with your friends? What do you do for fun?
Optional probe: Bullying |
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Care provider's notes
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How often are you using drugs or alcohol? |
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Care provider's notes
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Do you have any thoughts of wanting to kill yourself? How would you do it? When would you do it? Have your thoughts of suicide changed? |
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Care provider's notes
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| E |
motions, behaviours, thought disturbance |
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How have you been feeling lately? Do you ever get any bad thoughts that you can't get out of your head? Do you get into any trouble with parents, police, school etc.? |
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Care provider's notes
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Do you have any help or are you waiting to receive help (counselling etc)? |
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Care provider's notes
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