Are difficulties related to a neurological problem or recent injury?
What are your concerns regarding skills?
BEHAVORIAL CONCERNS: Physical Aggression, Sexual Inappropriateness, Verbal, Over Stimulated/Sensory Overload, Substance Concerns, Elopement/Abrupt Departure
What therapeutic services are being requested?
(Evaluation, supplement assessment, OT, Cog/Sp, PT, Group Tx, Residential, Vocational/Job Training)
Neuropsych evaluation available?
Able to speak (method of communication)?
Able to walk (use of cane or wheelchair)?
What was your previous employment (if any)?