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EAP CLINICAL ASSESSMENT FORM To be completed on every EAP referral. Client Name:Date of Assessment:Employee Name:Employer:Occupation:SelfProvider Name (print):Social Security #:Date of Birth:Employer×EAP

How to fill out eap clinical assessment form

How to fill out eap clinical assessment form

1. To fill out the EAP clinical assessment form, follow these steps:
2. Start by entering the client's personal information, such as their name, date of birth, and contact details.
3. Provide details about the client's presenting issues and reasons for seeking assessment.
4. Include a brief medical history, including any relevant medications or diagnoses.
5. Describe the client's current living situation, including their housing, support network, and any potential barriers to treatment.
6. Assess the client's social and occupational functioning, including their employment status and relationships.
7. Evaluate the client's mental health symptoms and their severity.
8. Include information about the client's prior treatment history, including any previous therapy or psychiatric interventions.
9. Collect information about any current or potential risk factors, such as suicidal ideation or self-harm.
10. Include any additional information or concerns that may be relevant to the assessment process.
11. Review the form for accuracy and completeness before submitting it for further evaluation.

Who needs eap clinical assessment form?

1. The EAP clinical assessment form is typically needed by individuals who are seeking clinical assessment services. This includes individuals who may be experiencing mental health symptoms, seeking therapy or psychiatric interventions, or require an evaluation of their overall functioning. The form helps gather important information that can aid in the assessment and treatment planning process.

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What is eap clinical assessment form?

The EAP (Employee Assistance Program) clinical assessment form is a document used to evaluate an individual's mental health and determine the appropriate course of action for treatment and support.

Who is required to file eap clinical assessment form?

Employees who are seeking assistance through the EAP program are required to file the clinical assessment form.

How to fill out eap clinical assessment form?

The form can be filled out by the employee with the help of a counselor or mental health professional. It typically requires personal information, details of the issue, and consent for treatment.

What is the purpose of eap clinical assessment form?

The purpose of the EAP clinical assessment form is to provide a comprehensive evaluation of an individual's mental health needs and create a plan for appropriate support and treatment.

What information must be reported on eap clinical assessment form?

The form typically requires information about the individual's mental health history, current symptoms, stressors, and any previous treatments or medications.