As we get started and periodically throughout the time we work together we need to look at your symptomology to see if you have any symptoms we need to address in treatment or to be sure your symptoms if there are any are improving. We will chart your progress as we work together. One of the ways we note improvement is symptom reduction. However, as we start and when we check up in order to ensure accuracy of symptoms we need your input as to how you are doing. As you fill out the following questionnaire try to be completely accurate and honest in your description of any current symptoms you may have. Current symptoms are those you have experienced within the last seven days including today. We would rather you be accurate than miss something significant we should be either dealing with or monitoring on your behalf.

Your may complete the form in one of two ways.

• The printable version can be printed, completed, and brought with you to your next session.
• The Online version consists of six input pages. As you complete each page, your answers will be emialed to your counselor, who will print a copy for review and discussion at your next session.

Regardless of which version you choose, please complete the entire form.  Click the version you would like to complete, to begin.