|Well-Being Signs (WBS)
| Gender: <.Patient_Gender.>
|
| WBS Average Score: <*Answer_7771*>
|
|
|Questions and Answers:
|
| Over the past 3 months what percentage of the time have you been:
|
| 1. Fully satisfied with how things are going in these aspects of life?
|
| <*Answer_8692*>
| 2. Regularly involved in all aspects of life that are important to you?
| <*Answer_8693*>
| 3. Functioning your best in aspects of life that you do participate in?
| <*Answer_8694*>
|
|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.
| 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.>)
|
