Functional minds (adolescent rating scale)

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Kitrin

Your Growth is Our Business

Adolescent rating scale

In the past 2 weeks, how have you managed the following topics? A 10 is well and 1 is poor.

Name *

First

Last

Date of Birth *

Regulating your emotions *

School and school related tasks *

Self-esteem *

Relationship (communication, openness, boundaries) with parents *

What is your expectation(s) in therapy? *

What is your parent's expectation(s) of therapy? *