This assessment is for my:
Son
Daughter
Has your child had recurring problems due to:
Any traumatic events/changes such as abuse, divorce, or death, in his life?
Yes
No
Inability to manage anger?
Yes
No
Within the last six months, has your child:
Disregarded family rules and parental guidance?
Yes
No
Had any changes in behavior and/or mood?
Yes
No
Exhibited depressive symptoms, such as weight loss/gain or excessive sleep?
Yes
No
Had problems getting along with others?
Yes
No
Do you suspect that your child has used drugs or alcohol?
Yes
No
Had problems in school such as poor grades or challenging authority?
Yes
No
Has your child been able to manipulate people and situations in order to escape consequences?
Yes
No
Been destructive to property?
Yes
No
Intentionally frightened others?
Yes
No
Made threatening statements in writing?
Yes
No
Implied that they may have a plan for violent or suicidal behavior?
Yes
No
Implied that they have identified a target for violence?
Yes
No