193 (193)    MH REPORT (601.93)

|Brief Inventory of Psychosocial Functioning (B-IPF)
|   Gender: <.Patient_Gender.>
|  
|   B-IPF Total Score = <-B-IPF Total->  (<*Answer_7772*>)
|  
|  
|Questions and Answers:
|  
|   1.  I had trouble in my romantic relationship with my spouse or partner.
|       <*Answer_8643*>
|   2.  I had trouble in my relationship with my children.
|  
|       <*Answer_8644*>
|   3.  I had trouble with my family relationships.
|       <*Answer_8645*>
|   4.  I had trouble with my friendships and socializing.
|       <*Answer_8646*>
|   5.  I had trouble at work.
|       <*Answer_8647*>
|   6.  I had trouble with my training and education.
|       <*Answer_8648*>
|   7.  I had trouble with day to day activities, such as doing household
|   Date Given: <.Date_Given.>
|       chores, running errands and managing my medical care.
|       <*Answer_8649*>
|  
|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.
|   Clinician: <.Staff_Ordered_By.>
|   Location:  <.Location.>
|  
|   Veteran:  <.Patient_Name_Last_First.>
|   SSN: <.Patient_SSN.>
|   DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)