| RPT |
|Enhancing Quality of Care in Psychosis||Date Given: <.Date_Given.>|Clinician: <.Staff_Ordered_By.>|Location: <.Location.>||Veteran: <.Patient_Name_Last_First.>|SSN: <.Patient_SSN.>|DOB:
your doctor for mental health problems?| <*Answer_4429*>|26.Do you know the names of your medications that you are prescribed?| <*Answer_4430*>|27.Here is a list of medications you may be
prescribed. Check all of the medications that you are currently prescribed.| <*Answer_4431*>|28.Over the past month, to what extent have you taken the medications prescribed by your doctor for
mental health problems?| <*Answer_4432*>|29.What is your height: How many feet?| <*Answer_4433*>|How many inches:| <*Answer_4434*>|30.What is your weight in pounds?|
<*Answer_4435*>|31.Have you been weighing yourself every week at home?| <*Answer_4436*>|32.Over the past month, have you gained or lost weight or stayed the same?| <*Answer_4437*>|33.How
much weight have you gained?| <*Answer_4438*>|34.How much weight have you lost?| <*Answer_4439*>|35.Has your doctor recently talked with you about changing to medication that does not cause
weight gain?| <*Answer_4440*>|36.Has your doctor recently recommended that you go to wellness or weight loss groups?| <*Answer_4441*>|37.How many times in the past month did you attend
wellness or weight loss groups?| <*Answer_4442*>|39.Have you changed your diet in order to lose weight?| <*Answer_4443*>|40.Have you increased your physical activity recently in order to lose
weight?| <*Answer_4444*>|41.Have you ever had angina, a heart attack, or a stroke?| <*Answer_4445*>|42.Do you currently have diabetes or hypertension, or are you being treated for diabetes or
hypertension?| <*Answer_4455*>|43.Are you currently working in a job for pay?| <*Answer_4446*>|44.How many weeks have you worked at this job?| <*Answer_4447*>|45.How many hours a week do
you usually work?| <*Answer_4448*>|46.Is this a job that anyone can apply for, or is it only for disabled people?| <*Answer_4449*>|47.How many dollars did you earn last month?|
<.Patient_Date_Of_Birth.> (<.Patient_Age.>)|Gender: <.Patient_Gender.>|||1.Managing your day-to-day life?| <*Answer_4405*>|2.Coping with problems in your life?|
<*Answer_4450*>|48.Is this the total gross income from the job, or the amount of take-home pay from the job?| <*Answer_4456*>|49.Would you be interested in working at a paying job if it would
not affect your benefits too much and you could get the support you need?| <*Answer_4451*>|50.Has your doctor recently recommended that you go to the VA's work program---called "IPS" or
"supported employment" ?| <*Answer_4452*>|51.How many times in the past month did you attend the VA's work program called IPS or supported employment?| <*Answer_4453*>|52.During the past
month, how many job interviews have you gone to?| <*Answer_4454*>| $~
<*Answer_4406*>|3.Concentrating?| <*Answer_4407*>|4.Get along with people in your family?| <*Answer_4408*>|5.Get along with people outside your family?| <*Answer_4409*>|6.Get along well
in social situations?| <*Answer_4410*>|7.Feel close to another person?| <*Answer_4411*>|8.Feel like you had someone to turn to if you needed help?| <*Answer_4412*>|9.Feel confident in
yourself?| <*Answer_4413*>|10.Feel sad or depressed?| <*Answer_4414*>|11.Think about ending your life?| <*Answer_4415*>|12.Feel nervous?| <*Answer_4416*>|13.Have thoughts racing
through your head?| <*Answer_4417*>|14.Think you had special powers?| <*Answer_4418*>|15.Hear voices or see things?| <*Answer_4419*>|16.Think people were watching you?|
<*Answer_4420*>|17.Think people were against you?| <*Answer_4421*>|18.Have mood swings?| <*Answer_4422*>|19.Feel short-tempered?| <*Answer_4423*>|20.Think about hurting yourself?|
<*Answer_4424*>|21.Did you have an urge to drink alcohol or take street drugs?| <*Answer_4425*>|22.Did anyone talk to you about your drinking or drug use?| <*Answer_4426*>|23.Did you try to
hide your drinking or drug use?| <*Answer_4427*>|24.Did you have problems from your drinking or drug use?| <*Answer_4428*>|25.Over the past month have you been prescribed any medication by
|
