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transformations health services cincinnati ohio

Confidential Mental Health Assessment

1. Do you find yourself sad, anxious, irritable, or worried most days of the week for long periods of time?
2. Do you have trouble falling asleep or staying asleep?
3. Do you feel fatigued or lethargic most of the time, no matter how much sleep you get?
4. Do you ever feel like you are being watched, fearful that someone is constantly out to get you?
5. Do you continually experience racing, intrusive thoughts that you can’t seem to quiet?
6. Do you ever feel a sensation of deep euphoria for no apparent reason, almost as if you could conquer anything?
7. Do you ever compulsively engage in behaviors that you later regret or could compromise your safety (e.g. gambling, over-spending, shoplifting, or risky sexual behavior)?
8. Do you ever feel unable to relax if things aren’t exactly symmetrical, perhaps engaging in habitual counting or reordering of objects?
9. Have you ever heard a voice or seen something that you later realized was not really there or was not observed by others?
10. Do you ever feel unable to leave your home, even when you have work, school, or social responsibilities?
11. Do you ever restrict your food intake or overeat to the point of sickness?
12. Do you struggle to control your temper, often feeling high levels of rage?
13. Do you regularly use substances like alcohol or illicit drugs, often feeling unable to function without them?
14. Do you ever have thoughts of harming others, and have you ever made a plan to do so?
15. Have you had thoughts of harming yourself, or have you ever made an attempt to take your own life?

Thank you for sharing with us.

A member of our team will get back to you shortly!


3650 Muddy Creek Rd

Suite 100 

Cincinnati, OH 45238


(513) 347-0375

Fax Number

(513) 347-0376



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