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    Mental Status Exam R3

    Uploaded by

    Natasha Taylor
    This document contains a Mini Mental Status Exam checklist to assess a client's appearance, appetite, behavior, thoughts, mood, orientation, sleep, speech, suicidal ideation, and memory. The checklist includes options to check off observations such as well-groomed, depressed mood, adequate orientation to time and place, and no reported memory impairment. It also provides space to further describe any checked items as necessary.

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    © All Rights Reserved
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    Mental Status Exam R3

    Uploaded by

    Natasha Taylor
    170 views1 page
    This document contains a Mini Mental Status Exam checklist to assess a client's appearance, appetite, behavior, thoughts, mood, orientation, sleep, speech, suicidal ideation, and memory. The checklist includes options to check off observations such as well-groomed, depressed mood, adequate orientation to time and place, and no reported memory impairment. It also provides space to further describe any checked items as necessary.

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    diagnositic

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    This document contains a Mini Mental Status Exam checklist to assess a client's appearance, appetite, behavior, thoughts, mood, orientation, sleep, speech, suicidal ideation, and memory. The checklist includes options to check off observations such as well-groomed, depressed mood, adequate orientation to time and place, and no reported memory impairment. It also provides space to further describe any checked items as necessary.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    170 views1 page

    Mental Status Exam R3

    Uploaded by

    Natasha Taylor
    This document contains a Mini Mental Status Exam checklist to assess a client's appearance, appetite, behavior, thoughts, mood, orientation, sleep, speech, suicidal ideation, and memory. The checklist includes options to check off observations such as well-groomed, depressed mood, adequate orientation to time and place, and no reported memory impairment. It also provides space to further describe any checked items as necessary.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    Mini Mental Status Exam

    Check all that apply

    __________________________________________________________________________________________
    Client Name Date of Birth Date of Exam

     Well groomed  Appropriate  Odd  Disheveled  Dirty


    Appearance
     Well nourished 
     Emaciated  Slender  Overweight  Obese

     Good  Fair  Poor  3 meals/day


    Appetite
     Binge  Restrict  Purge  Excessive Exercise
    Assaultive  None Reported  Passive Ideation  Plan / Gesture  Means Access  Access
    Behavior  Cooperative  Guarded  Withdrawn  Acting Out  Other
    Delusions/
     Auditory  Visual  Olfactory  Paranoid
    Hallucinations
    Homicidal  None Reported  Passive Ideation  Plan / Gesture  Means  Access

    Impulse Control  Adequate  Inadequate  Loss of Control

    Insight  Good  Fair  Poor


    Mood/Affect  Appropriate  Depressed  Anxious  Elevated  Tearful
    Orientation  Time  Place  Person
    Self-Care  Adequate  Inadequate

    Sleep  Well Rested  Insomnia  Hypersomnia  Early/Frequent  Nightmares


    Awakenings
    Speech  Clear  Pressured  Slow  Inarticulate  Alogia

    Suicidal Ideation  None Reported  Passive Ideation  Plan / Gesture  Means  Access

     Logical  Abstract  Racing  Tangential  Loose


    Thought
     Goal Directed  Circumstantial 
    Memory
    Impairment  Yes  No  Short term loss  Long term loss

    Further description of above if necessary:

    Documentation WizardTM © 2017 all rights reserved Mini Mental Status Exam

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