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Psychology
Pre-booking Screening

Are you currently experiencing hearing, seeing, or feeling things that other people say are not there?
Yes
No

For example hearing voices, seeing things others cannot see, or feeling sensations on or under your skin that others do not experience.

Are you currently having thoughts of suicide, or thoughts of ending your life? This includes passing thoughts with a plan or intent.
Yes
No

If you select "Yes" to above question, Telehealth is NOT appropriate for you.

Have you self-harmed today, or at any point in the past 7 days? This includes any act of deliberate self harm, regardless of intent or severity.
Yes
No

If you select "Yes" to above question, Telehealth is NOT appropriate for you.

Are you currently having thoughts of harming someone else? This includes thought, plans or urges to hurt another person.
Yes
No

If you select "Yes" to above question, Telehealth is NOT appropriate for you.

Do you have problem with substance abuse?
Yes
No

If you select "Yes" to above question, Telehealth is NOT appropriate for you.

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