Mental Health Assessment

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June 29, 2024

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PSYCHOLOGICAL EVALUATION FORM

EU Certificate Number: 714751

PERSONAL DETAILS

Name: MOHAMMAD NASIM ID/Passport Number: P02504021

Nationality: AFGHANISTAN Phone Number: +965********

Date of Birth’ 197911 Gender: FEMALE

EVALUATION DETAILS

Examination Method: ONLINE EVALUATION Examination Time 30 MINUTES

CHAPTERS TESTED 01234

1. Personality Test, x

2. Mental Health Assessment x

3. Alcoholism Test x

4, Cognitive Symptoms x

5. Drug Abuse Test x

6. Anxiety Disorder Test x

7. Woman Abuse Test x

Difficulty: 0 (Easy) 1 (Medium) 2 (Advanced) 3 (Herd) 4 (Very Hard)

REPORT 01234

Obtains sufficient data for DSM Axis I-V differential diagnosis, x

Obtains psychiatric, medical, family and social histories x

Screens for suicidal and homicidal ideation x

Performs an adequate mental status answers x

Antecedents of suicideal behavoir x

Result: 0 (Unacceptable/Nonexistent) 1 (Probably) 2 (Acceptable) 3 (Very Acceptable) 4 (Complete)

lam here to certify that Ms. Mohammad Nasim does not suffer from any mental illness

and that she is fit to work under pressure and make decisions in stressful situations.

This forth respects the Mental Health Act No. 1116/1990, sections L.3212-1 et seq.,

L.3213-1 et seq. of the EU Public Health Code and ILO for the protection of individual liberties

and examination.

certify that the above information is complete and true. understand that false,

inaccurate, or missing information may invalidate this certificate.

Name and signature Examiner S/ Date

Mohammad Nasim Dr. Bosil 12-07-2023