Developmental History (write in the space given if you have specific comments):
-Typical
-Concerns
-Learning problems
-Social problems (at school)
-List specific concerns you may have regarding relationships, anxiety, depression, etc. and whether you have received treatment in the past.
-List any medical treatments you have received in the past, including chronic medical conditions (e.g. diabetes), injuries, and/or surgeries.
-Current and/or past use of drugs/alcohol.