HOW ARE YOU DOING?
Indicate how you are currently doing in various domains of your life. This will give me an indication what to pay attention to in our upcoming session and will also allow me to track how you are doing over time and see if things are getting better or not. Complete this form on the day before you have a session. You can use your name or a name code (made up of your initials and last two digits of your birth year). Thanks. Dr. Dummer
Name or Name Code *
How are you doing as far as your personal well being? *
terrible
excellent
How are you doing with family and loved ones? *
terrible
excellent
How are you doing with work, school, people in general? *
terrible
excellent
How are you doing in general, overall? *
terrible
excellent
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