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Dr. Mudassar Tariq, MD
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2023-01-27T11:14:29-06:00
First Name
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Last Name Initial
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Age
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Please check the name of clinician your appointment is scheduled with
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Dr. Mudassar Tariq
Date of Appointment
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Appointment time
Please check the problems you are being treated for in our office
anxiety
depression
bipolar
adhd
insomnia
ptsd
ocd
panic attacks
psychosis
eating disorder
On a scale of one to ten, how bad has been your anxiety. One would mean no anxiety and 10 means worst anxiety
On a scale of one to ten, how bad has been your depression. One would mean no depression and 10 means worst depression
Since your last visit, which of the following Anxiety symptoms have been present?
worrying excessively
feeling tense for no or minor reasons
expecting worse
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