Patient Preliminary Interview

How decisive are you about making you mind up about things?

Have you lost interest or pleasure in things you used to enjoy?

Are you having trouble falling asleep or staying asleep?

Are you more irritable lately, feeling resentful, and angry frequently?

Are you having trouble concentrating or focusing?  Is it difficult to get things done?

Do you worry a lot?

Is your energy level low?

Do you feel bad about yourself, your appearance, your accomplishments or your efforts?

Your e-mail address or phone number:

Your name: