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The document is an 'Examining Physician’s or Psychologist’s Report' used in legal proceedings to assess an individual's need for a guardian or protective services. It outlines the examination process, rights of the individual being evaluated, and definitions related to various disabilities and incapacities. The report includes sections for the examiner to provide personal details, medical history, evaluation findings, and recommendations regarding the individual's capacity to make decisions and their need for guardianship or protective placement.

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Click ‘Get Form’ to open the psychologist report sample in the editor.
Begin by entering the case number and personal details of the individual, including their name, date of birth, age, gender, and marital status. This information is crucial for identifying the subject of the report.
In the 'Examiner' section, input your name and credentials. Ensure that you have read the 'Statement to be Read' to the individual before proceeding with the evaluation.
Proceed to answer each question in detail. For instance, assess and document the individual's level of intelligence and functional knowledge in sections provided. Use checkboxes where applicable for clarity.
Complete all sections regarding examination findings, including orientation, attention/concentration, memory, and reasoning. Be thorough in your observations as these will inform legal decisions.
Finally, review your entries for accuracy before saving or exporting the completed report. You can easily share it directly from our platform for further processing.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What does a psychologist have to report?

There are some situations where a therapist legally must disclose information to the police under California law. Counselors are required to tell the police or the potential victim what a patient has told them if they believe their client may hurt someone else in the future.

How to write a psychological intake report?

Your intake note should contain a full medical (biological), behavioral, and social history for the patient. This is what makes it an intake note: Youre understanding the patients background before they started working with you. This part of your intake note might include: Medical conditions.

How to write a psychologist report?

7 Tips for Psychological Evaluation Report Writing Create a Psychological Evaluation Reporting Template. Collect Accurate Data. Interpret Test Results in Your Reports. Make the Report Concise and Useful. Consider Your Readers. Tell a Narrative. Use PhraseExpander A Text Expansion Tool for Therapists. Conclusion.

What can a therapist not report?

In most cases, therapists are bound by confidentiality, and legal reporting is rare. However, there are exceptions if a client poses a serious threat to themselves or others, or if theres suspected child or elder abuse. Additionally, disclosure may occur under court order.

What can a psychologist disclose?

Psychologists may disclose private information without consent in order to protect the patient or the public from serious harm if, for example, a client discusses plans to attempt suicide or harm another person.

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What is included in a psychological assessment report?

Your reports should include various elements such as background information, reason for referral, procedures used, clinical impressions, diagnosis, and recommendations. These reports can be invaluable tools for clients and clinicians when done well.

Do I have to tell my psychologist everything?

Try not to tell your therapist only part of the story. Thats why, to receive the appropriate support and guidance and to achieve the utmost personal growth, you should tell your therapist the whole truth.

Psychologist report sample 2025

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What does a psychologist have to report?

How to write a psychological intake report?

How to write a psychologist report?

What can a therapist not report?

What can a psychologist disclose?

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What is included in a psychological assessment report?

Do I have to tell my psychologist everything?

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