| RPT |
.| .| Social Problem-Solving Inventory--Revised, Short Form| | Date Given: <.Date_Given.>| Clinician: <.Staff_Ordered_By.>| Location: <.Location.>| | Veteran:
<.Patient_Name_Last_First.>| SSN: <.Patient_SSN.>| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)| Gender: <.Patient_Gender.>| | | <.DLL_String.>| | | 1. <*Answer_6639*> 2.
<*Answer_6640*> 3. <*Answer_6641*> | 4. <*Answer_6642*> 5. <*Answer_6643*> 6. <*Answer_6644*> | 7. <*Answer_6645*> 8. <*Answer_6646*> 9. <*Answer_6647*> | 10. <*Answer_6648*> 11.
<*Answer_6649*> 12. <*Answer_6650*> | 13. <*Answer_6651*> 14. <*Answer_6652*> 15. <*Answer_6653*>| 16. <*Answer_6654*> 17. <*Answer_6655*> 18. <*Answer_6656*> | 19. <*Answer_6657*> 20.
<*Answer_6658*> 21. <*Answer_6659*> | 22. <*Answer_6660*> 23. <*Answer_6661*> 24. <*Answer_6662*> | 25. <*Answer_6663*>| | Copyright (c) 1996, 2002 Multi-Health Systems, Inc. All rights
reserved.| | Information contained in this note is based on a self-report assessment and is not sufficient to use alone for diagnostic purposes. Assessment results should be verified for accuracy
and used in conjunction with other diagnostic activities and procedures.| | | $~
|
