Question:
Can someone direct me to the web site that has psy eval forms?

I just received a cancellation appt for a psych eval for tomorrow! I'd like to be able to take this to this doctor so that he can just complete it and submit to the surgeon for clearance, plus it's easier because he's never done this for an "elective" surgery before. Please help.    — Kimberly D. (posted on June 11, 2001)


June 11, 2001
Here are the requirements for psych eval that my surgeon gave to me the day of my evaluation: 1.Identifying Information...name, address, sex, age, referring physician's name (not your surgeon). 2.Reason for the referral...Indicate the patient was referred for a psych eval to assess the following: Patient's appropriateness for gastric exclusion surgery and the patient's postoperative complicance with dietary requirements and procedures. 3. Mental status 4. Psychological history...marital history and current social support, history of being overweight, history of weight loss, family history, personal history including employment, presence of other addictive behaviors (IE substance abuse) and previous psychological treatment. 5. Assessment results...Indicate assessment device (MMPI-2 or MCMI-3) and results. Include copy of the patient's profile along with the report. Comment on overall results of the testing and relate them to the psychological criteria listed below (IE compliance with dietary restrictions, need for additional psychological support). 6. Indicate if the patient meets the following psychological criteria for surgery and include your rationle: Is the patient motivated to have the surgery? Why? Does the patient understand the procedure and aftercare requirements? Does the patient have a plan for their aftercare? Indicate your impression of their social support system. Are there any factors which may interfere with compliance to dietary restrictions and postoperative instructions? If the patient does not presently meet the psychological criteria for surgery, indicate your recommendations regarding interventions and, if appropriate, a follow-up plan for reassessment. Is psychological support needed prior to, or following, the procedure? Indicate if you are available to provide this support or assist the patient with an ajpproproate referral. If you have any questions please consult with the surgeon's office or the surgeon's consulting psychologist's office. Physicians may send their results to: yadayadayada
   — Judith A.




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