Weight Loss MD

A person in a white coat writes on a clipboard at a desk.
Next, let’s go through your health history.
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Before we get started - How are you feeling today?
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Is there a particular medication you are interested in or prefer?
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How much experience do you have with medication?
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Over the last 2 weeks, how often have you been bothered by having little interest or pleasure in doing things?
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Over the last 2 weeks, how often have you been bothered by feeling down, depressed, or hopeless?
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Over the last 2 weeks, how often have you been bothered by trouble falling/staying asleep, or sleeping too much?
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Over the last 2 weeks, how often have you been bothered by feeling tired or having little energy?
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Over the last 2 weeks, how often have you been bothered by poor appetite or overeating?
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Over the last 2 weeks, how often have you been bothered by feeling bad about yourself, that you are a failure, or have let yourself or your family down?
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Over the last 2 weeks, how often have you been bothered by trouble concentrating on things such as reading newspapers or watching tv?
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Over the last 2 weeks, how often have you been bothered by moving or speaking so slowly that other people have noticed, OR being so fidgety or restless that you have been moving around a lot more than usual?
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Over the last 2 weeks, how often have you been bothered by feeling nervous, anxious or on edge?
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Over the last 2 weeks, how often have you been bothered by not being able to stop or control worrying?
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Over the last 2 weeks, how often have you been bothered by worrying too much about different things?
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Over the last 2 weeks, how often have you been bothered by trouble relaxing?
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Over the last 2 weeks, how often have you been bothered by being so restless that it is hard to sit still?
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Over the last 2 weeks, how often have you been bothered by becoming easily annoyed or irritable?
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Over the last 2 weeks, how often have you been bothered by feeling afraid as if something awful might happen?
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In the past two weeks, how difficult have your problems made it for you to do work, take care of things at home, or get along with other people?
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A person in a white coat writes on a clipboard at a desk.
Almost done! Next, we have a few medication-specific questions.
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What are the primary issues that brought you in today?
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Have you been diagnosed or have a history of any of the following mental health conditions?
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Have you been hospitalized for any mental health reasons and/or visited a crisis center or emergency room in the past?
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How have you been feeling for the past few weeks?
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How has your sleep been?
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How has your appetite been?
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Do you have a family history of mental health issues: depression, anxiety, bipolar, schizophrenia, substance abuse, etc?
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Is there a specific mental health medication you are interested in?
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Is there a specific dosage you are happy with?
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Are you currently taking other prescription medication, over-the-counter medication, supplements or herbal remedies ?
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What is your identified gender?
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What was your sex assigned at birth?
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Are you currently pregnant or trying to conceive?
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Do you have or have you ever had any of the following medical conditions?
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Do you smoke or use other tobacco products?
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How often in the last year have you had 4 or more alcoholic drinks on one occasion?
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Are you currently using any of the following recreational drugs?
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Have you ever had any surgeries or hospitalization?
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Do you have any allergies to medications, dyes, food or anything else?
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In case of an emergency, is there someone you want us to contact?
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Is there anything else your provider should know to better tailor your treatment plan?
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All set. Thanks
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doc4881
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