Initial Psychiatric Assessment: A Practical Guide To The Clinical Interview Page 2

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3. PSYCHIATRIC HX
Previous psychiatric Hx/Counseling/Suicide attempts/Violence:
Previous diagnoses:
Medications/Tx:
4. FAM PSYCHIATRIC HX
Psychiatric Dx/Visits/Counseling/Suicide attempts:
Substance use:
Suicide:
5. MEDICAL HX
6. SYSTEMS REVIEW
Previous illnesses & treatment:
CNS:
H & N:
Surgeries/hospitalizations:
CVS:
Head injury (+/- LOC) and workup/imaging:
RESP:
Medications:
GI:
GU:
Alcohol use:
MSK:
Substance use: (caffeine, nicotine, over-counter/illicit med/drugs)
DERM:

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