Dear Dr. X:

Thank you for your referral of X.

OP: The patient was seen by myself and by Dr. X from Xpm until Xpm

X was referred for REASON in the context of THEIR  DX(es)

Thank you for your referral of NAME

IP: I met with them in their room, and THEY was later seen by the attending psychiatrist Dr X.

X was admitted with suicidal ideation, having identified a plan for taking THEIR life.

Identification: X year old MALE/FEMALE who lives in CITY with THEIR X .THEY are supported financially by THEIR JOB (SPECIFY)

HPI:

NARRATIVE SUMMARY. INCLUDE SUMMARY OF PAST PSYCH HX, PRECIPITATING FACTORS, WHAT HAPPENED TO GET TO THE ADMISSION. INCLUDE HOW PT FOUND THEMSELVES IN THE HOSPITAL/APPT. INCLUDE SX (PERTINENT POSITIVES AND NEGATIVES) LEADING TO ANY DX

SECOND PARAGRAPH NOTING ADDITIONAL MENTAL HEALTH CONSIDERATIONS THAT MAY NOT ENCOMPASS THE CURRENT SITUATION, SUCH AS AN ANXIETY DISORDER UNRELATED TO THE CURRENT PRESENTATION. ADDITIONAL PARS AS NEEDED.

Substances: NAME uses X, AMOUNT AND FREQ. Denies use of ..., and other recreational drugs

Psych history:  No prior admissions, no previous suicide attempts. THEY has a counsellor with whom THEY has had X sessions so far. NOTE OTHER MH EXPERIENCES

Family Psych history: MH OF THOSE RELATED BY BLOOD. INCLUDE SUBSTANCE USE DISORDERS.

Medical history:

1. LIST

Surgical history:

1. LIST

Allergies:

1. LIST