Crisis Application Assignment 2

NCE stduyNNCC

Observations (Check all that apply)

___ off medication*

___ hallucinating† (___smells ___sights ___sounds ___touch)

___ bizarre behavior/appearance

___ poor hygiene

___ absurd, illogical, nonsensical speech

___ paranoid/suspicious thoughts

___ flashbacks, loss of reality contact*

___ intoxicated/drugged*

___ possible developmental disability

*Support services recommended.

†Protective custody recommended.

___ aggressive gestures

___ physically violent†

___ verbal threats to self or others

___ suicidal/homicidal thinking/verbalizing*

___ suicidal/homicidal gestures/behaviors†

___ suicidal/homicidal plan clear†

___ uncooperative

___ reckless behavior

___ impulsivity

___ hysterical*

___ confusion*

___ unable to follow simple directions*

___ unable to control emotions

___ cannot recall personal information*

(phone, address)

___ situation perceived as unreal*

(spectator)

___ nonresponsive*