.| .| Brief Resiliency Scale| | 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.>| | | | Brief Resiliency Scale Score: <-BRS->| | | Please make a check mark in the appropriate box to indicate when you are
filling out this form:| <*Answer_6022*>| | Questions and Answers:| | 1. I tend to bounce back quickly after hard times.| <*Answer_6023*>| 2. I have a hard time making it through stressful
events.| <*Answer_6025*>| 3. It does not take me long to recover from a stressful event.| <*Answer_6401*>| 4. It is hard for me to snap back when something bad happens.| <*Answer_6402*>|
5. I usually come through difficult times with little trouble.| <*Answer_6403*>| 6. I tend to take a long time to get over setbacks in my life.| <*Answer_6404*>| | | 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.| $~
|
