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PATIENT HEALTH QUESTIONNAIRE (PHQ-9) Patient Name: Date of Birth: Date: Over the last 2 weeks, how often have you been bothered by any of the following problems? Not at all Several days More than
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Start by gathering all necessary information, such as the individual's personal details and the reason for filling out the not-at form.
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Include the date or dates when the individual was unable to be present at the specified location. Be sure to accurately indicate the duration of the absence.
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If possible, provide any supporting documentation or evidence to validate the reason for not being present. This could be a doctor's note, travel documents, or any other relevant paperwork.
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