Purpose Of Psychological Evaluation Report

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I met with Ms. McGuvyer (Ms. M) on 10/10/2016 for a psychological evaluation. Ms. M was informed that the purpose of the psychological evaluation was to assess her emotional and psychological functioning. She was informed of the limits of confidentiality, including the examiner’s mandated reporting responsibilities, regarding the disclosure of potentially harming himself or others, and child or vulnerable adult abuse. She was made aware that the information gathered during the evaluation was confidential and would not be disclosed without her consent. Ms. M was made aware that if she wanted a copy of her evaluation sent to her primary care physician (PCP) Dr. Ino Lotts, then she would be required to provide written consent, limits of confidentiality and release of information.

REASON FOR REFERRAL
Ms. M was referred by her PCP, Dr. Ino Lotts, for a
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M was a 47-year-old single, right-handed, heterosexual White female who lived alone in Glendale, Arizona.

Familial History and Significant Relationships
Ms. M stated that she grew up in Wisconsin with her biological parents, three brothers, and two sisters, all of which she is still close with. She denied any significant conflict, abuse, and/or domestic violence within her family. She also reported that she has never been married and stated that she has not dated frequently throughout her life.

Education and Employment History
Ms. M stated that she mostly liked school and she liked most of her classes while growing up. Specifically, she said that her favorite classes included art, physical education, and wood working, and that she was an A and B student. Ms. M also denied being in any special classes throughout her education. Her highest level of education achieved was an associates degree.

Prior to obtaining a job as a graphic designer, Ms. M stated that she waited tables.

Medical

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