|
Are you in a committed relationship:Find:Pt:^Patient:Ord:
|
|
|
|
Which household type do you live in:Find:Pt:^Patient:Ord:
|
|
|
|
What would you say how is the mental health of your partner is:Find:Pt:^Patient:Ord:
|
|
|
|
What would you say is the quality of your partnership:Find:Pt:^Patient:Ord:
|
|
|
|
Do you have underage persons in your household:Find:Pt:^Patient:Ord:
|
|
|
|
Number of underage persons in household:Num:Pt:^Patient:Qn:
|
|
{#}
|
|
For each underage person what would you say how is the mental health of underage person:Find:Pt:^Patient:Ord:
|
|
|
|
Mental health of household members comments:Imp:Pt:^Patient:Nar:
|
|
|