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Zumbro Valley Health Center
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  • Mental Health
    • Adult Counseling
      • ARMHS
      • Substance Use & Recovery Services
    • Integrative Healthcare & Wellbeing
    • Depression & Anxiety Treatment
    • Youth and Family Counseling
      • ADD/ADHD
      • Mood or Behavior Disorders
      • Trauma Treatment
      • Psychiatric Evaluation
      • Substance Use & Recovery Services
    • Community Support
    • Crisis & Residential Services
    • Telehealth
  • Substance Use
    • Detoxification
    • DUI Education
    • Counseling
    • Drug Testing Services
    • Support Groups
  • Medication Management
    • ADD/ADHD
    • Anxiety & Depression
    • Bipolar Disorder
    • Obsessive Compulsive Disorder
    • Post Traumatic Stress Disorder
    • Schizophrenia
  • Your Visit
    • What To Expect
    • About Us
    • Locations
    • Insurance Accepted
    • Client Forms
    • Make A Referral
  • Providers
    • Meet The Team
    • Leadership and Staff
    • Licensing and Certifications
    • Make A Donation
    • Annual Report
  • Resources
    • Classes & Groups
    • Types of Therapy
    • Teachers & Parents
    • Video Resources
    • FAQs
    • News

Adult Evaluation Form

  • Patient Health Questionnaire PHQ-9

    Over the last 2 weeks, how often have you been bothered by any of the following problems? Read each item carefully and mark your response.
  • AUDIT-C Questionnaire

  • Columbia-Suicide Severity Rating Scale

    Examples: Collected pills, obtained a gun, gave away valuables, wrote a will or suicide note, took out pills but didn't swallow any, held a gun but changed your mind or it was grabbed from your hand, wend to the roof but didn't jump; or actually took pills, tried to shoot yourself, tried to hang yourself, etc.
  • GAIN-Short Screener (GAIN-SS)

    The following questions are about common psychological, behavioral, and personal problems. These problems are considered significant when you have them for two or more weeks, when they keep coming back, when they keep you from meeting your responsibilities, or when they make you feel like you can't go on.
  • Lied or conned to get things you wanted to avoid having to do something
  • Had a hard time paying attention at school, work, or home
  • Had a hard time listening to instructions at school, work, or home
  • Were a bully or threatened other people
  • Started physical fights with other people
  • Current Symptoms

    Please check symptoms you currently experiencing
  • Finding Your ACE Score

  • Enter the total # of Yes answers.

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Zumbro Valley Health Center

507.289.2089

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  • Monday - Thursday - 7:30am - 7:00pm
  • Friday - 7:30am - 12:00pm
  • Emergency/Crisis Hotline 844.274.7472

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