Comprehensive Psychiatric Evaluation Template
With Psychotherapy Note
Encounter date: ______06/09/2023_____________
Patient Initials: __W.W.____ Gender: M/F/Transgender __Male__ Age: ___18__ Race: __Caucasian___ Ethnicity __White__
Reason for Seeking Health Care: ___ “I just cannot shake this constant feeling of worry and unease. I have always been anxious about everything in general but for the past 2 weeks my mind is always racing, and I can't seem to relax or enjoy anything anymore. This feeling has progressively become worse, and it's affecting my sleep and ability to concentrate especially in my school work.”