Psychiatric Evaluation Template
Diagnose mental health problems and disorders with the help of our psychiatric evaluation template. Click here for a guide and a free template copy!
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What is a Psychiatric Evaluation Template?
A psychiatric evaluation is a tool practitioners use to check their patient’s memory, behaviors, thought, etc., to diagnose one or several mental health disorders. Practitioners, primarily physicians, fill up a psychiatric evaluation form while conducting an interview.
Usually, the content of the evaluation form and the flow of the interview will vary depending on the physician in charge. However, there is a set of questions and sections they must ask the patient and/or the person accompanying the patient.
If you’re a physician and need a sample form you can edit, a guide for your interview, or even a document where you can record your patient’s answers, you can utilize our .
To provide you with a glimpse of what you can expect from our template so you can make the appropriate adjustments that’ll suit your needs and wants, we’ve listed down some of the sections included in the document below:
- Chief Complaint and Duration
- Clinical Review: Psychosocial History, Medical/Mental Health Treatment History, Educational/Work History, Social Work History, Family History
- Symptoms (e.g. Mood, Sleep, Guilt, Energy, Concentrating, Suicidal Ideation)
- Mental Status Exam: Appearance (e.g. Speech, Attitude and Behavior, Mood and Affect, Perception, Memory, Abstract Thought)
Find our template useful and want a copy to use in your practice? Keep reading for more details and a step-by-step on downloading and using our template.
Printable Psychiatric Evaluation Template
Download this Psychiatric Evaluation Template to diagnose mental health problems and disorders.
How does it work?
Step One. Access and Download the Template
Access and download our template by doing either of the following:
- Clicking the “Download Template” or “Use this Template” button above
- Searching for “Psychiatric Evaluation” on Carepatron’s template library on our website or app
Step Two. Fill in the Patient Information
Write down essential information such as the patient’s name and who they’re accompanied by, the interview date, date of birth, age, sex, gender, contact number, e-mail, and emergency contact person’s name and number.
Don’t forget to ask for the patient’s signature to signify their interview consent.
Step Three. Conduct the Interview
Our psychiatric evaluation has several sections, all of which you are encouraged to fill out, especially if you’re dealing with a new patient. We leave it to you to decide which questions and follow-up questions to ask to elicit an answer from your patient. However, we do recommend asking them open-ended questions.
Step Four: Review Your Notes and Secure Them
Once finished with your interview, you can review your notes to ask for further clarification from your patient or to organize them. Afterward, remember to either store your physical copies at a location with security measures set in place or at Careaptron with only limited viewing access to involved parties.
Psychiatric Evaluation Template Example (Sample)
Below is an example of a filled-out Psychiatric Evaluation in PDF form to give you an idea of how this assessment may look completed.
For an offline copy you can use for future reference, click the sample below or the “Download Example PDF” button above.
Download this Psychiatric Evaluation Template Example (Sample) here:
When would you use this Template?
As the expert, you would know best when to use this template. Should you need a guide, however, here’s a mix of the settings and situations where you can use our psychiatric evaluation form template.
Settings
- General medical such as hospitals or even emergency rooms
- Treatment or long-term care facilities
- Nursing homes
- Schools, prisons, etc.
Situations
- Checking both inpatients and outpatients
- General Psychiatric Evaluations and Clinical Consultations where you need to diagnose a mental disorder, collect data for diagnosis formulation, and develop or revise a treatment plan.
- Emergency Evaluations where the patient is exhibiting behavior that may harm themselves or others or feeling extreme distress that needs immediate intervention
Don’t forget that no matter where you’re planning to conduct the interview, you must obtain the patient’s consent, even if you’re going to ask the person accompanying them.
Benefits
Structured Interview
A psychiatric evaluation can take some time, especially for a general psychiatric assessment or clinical consultation. By having a template you can use as a guide and a document where you can record the result of the patient, you can efficiently conduct the interview, pinpoint what has to be expounded on, and write notes for future reference.
Fully Digital and Customizable
Since our template is fully digital, you can customize it to suit your needs. Feel free to ask more questions, relocate sections, or remove categories by editing it on Carepatron before downloading or printing it. Moreover, you can still fill out the template on Carepatron or any local PDF edit you have on your mobile gadgets.
Encourages Communication
Since our template consists mostly of blank spaces that give you the freedom to ask your own inquiries, preferably open-ended questions, you will be encouraged to communicate with your patient to elicit a response to your questions.
Accessible
As we’ve mentioned, our free psychiatric evaluation template is fully digital, which means you can access it on any gadget you have. Furthermore, if you store your notes on Carepatron, you can make the document accessible to relevant parties by giving them limited viewing access with a single click.
Why use Carepatron as your Psychiatric Evaluation Template app?
Beyond being a software where you can get the guide and Psychiatric Evaluation template, Carepatron is also a leading practice management software where you can automate administrative tasks. Doing this lets you streamline business and processes so that most of your focus, time, and effort goes toward patient care.
Aside from downloading and editing your Psychiatric Evaluation on our app, you’ll also have access to the following tools and resources for free:
- A variety of digitally editable, downloadable, and printable templates in PDF form of forms, surveys, tests, assessments, and other medical documents.
- A HIPAA-compliant, secure EHR system for all your client’s medical records and your digital notes.
- Integration of multiple calendars and telehealth software applications
- An automated payment system you can set up for your client
Download our application on your desktop or iOs/Android gadgets and sign up for Carepatron to get access to all of these and more!
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Commonly asked questions
Mental health practitioners more specifically psychiatrists and psychologists can utilize the psychiatric evaluation template.
You use a psychiatric evaluation template right at the beginning of a session to gather more information about them. For more specific situations or settings, please refer to the “When Would You Use this Template?” section above?
As often as needed especially if the patient has a new diagnosis or treatment plan.
