|
Date of service
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
MENTAL STATUS EXAM
|
Current Medications
|
|
Appearance
• • •
|
|
|
Speech
• • •
|
|
|
Behavior
• • •
|
|
|
Mood/Affect
• • •
|
|
|
Thought process
• • •
|
|
|
Judgment
• • •
|
|
|
Insight
• • •
|
|
|
Cognition
• • •
|
|
|
Thought content
• • •
|
|
|
Gait
• • •
|
|
