| RPT |
.| .| Social Skills Training - Veteran Outcome Survey| | Date Given: <.Date_Given.>| Clinician: <.Staff_Ordered_By.>| Location: <.Location.>| | Veteran: <.Patient_Name_Last_First.>| SSN:
sufficient to use alone for diagnostic purposes. Assessment results should be verified for accuracy and used in conjunction with other diagnostic activities and procedures.| $~
<.Patient_SSN.>| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)| Gender: <.Patient_Gender.>| | | <.DLL_String.>| | | SST-VOI| Satisfaction Score: <-Satisfaction->| Skill Score: <-Skill->| |
| Questions and Answers| | 1. How satisfied are you with the quality of your relationships with friends, family, and the other people in your life?| <*Answer_6861*>| 2. How skilled are you at
communicating with other people in your life?| <*Answer_6862*>| 3. How satisfied are you with your involvement in community activities? Community activities include working, volunteering, being a
student, or attending clubs and organizations.| <*Answer_6863*>| 4. How skilled are you at interacting with others in community settings? Community settings include a work or volunteer job site,
school, or clubs and organizations.| <*Answer_6864*>| 5. How satisfied are you with your relationships with the people who provide your mental health services?| <*Answer_6865*>| 6. How
skilled are you at interacting with your mental health service providers?| <*Answer_6866*>| 7. How would you rate your attendance for scheduled mental health appointments?| <*Answer_6867*>|
8. How satisfied are you with your overall health and well-being?| <*Answer_6868*>| 9. How skilled are you at managing your overall health and well-being?| <*Answer_6869*>| | What is the main
goal that the Veteran would like to reach with the help of Social Skills Training?| <*Answer_6870*>| | | Information contained in this note is based on a self-report assessment and is not
|
