Emotional Distress (depression, anxiety, tearfulness, excessive worry, irritability, not enjoying things they used to, grief/loss, trauma)

Yes

No

Unknown

MILD - My child does not have prior treatment history and/or their symptoms have limited impact on daily life

MODERATE - My child has symptoms that are negatively impacting their daily life in at least one area (school, home, relationships).

SEVERE

Mild - My child does not have prior treatment history and/or their symptoms have limited impact on daily life

MODERATE - My child has symptoms that are negatively impacting their daily life in at least one area (school, home, relationships).

SEVERE - My child's emotional difficulties are highly disruptive at home, in school and/or in the community; my child has a significant psychiatric diagnosis and/or is at risk of out-of-home placement/hospitalization or is being discharged from a hospital or out-of-home placement and we will need a high level of therapeutic support