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    General Health Profiling Students

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    Mohammad Matte Ullah
    This document outlines a general health profiling form for public/private school students over 12 years of age in Chakwal District. The form collects basic personal and medical history information, including family history of illness, past medical issues, substance abuse history, and physical measurements. It also screens for mental health issues like mood changes, risky behaviors, social issues, and signs of substance abuse. For students with initial risk factors, the form recommends further psychological assessment and potential drug screening to confirm suspected drug addiction issues.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    General Health Profiling Students

    Uploaded by

    Mohammad Matte Ullah
    277 views1 page
    This document outlines a general health profiling form for public/private school students over 12 years of age in Chakwal District. The form collects basic personal and medical history information, including family history of illness, past medical issues, substance abuse history, and physical measurements. It also screens for mental health issues like mood changes, risky behaviors, social issues, and signs of substance abuse. For students with initial risk factors, the form recommends further psychological assessment and potential drug screening to confirm suspected drug addiction issues.

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    GENERAL HEALTH PROFILING STUDENTS .docx

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    This document outlines a general health profiling form for public/private school students over 12 years of age in Chakwal District. The form collects basic personal and medical history information, including family history of illness, past medical issues, substance abuse history, and physical measurements. It also screens for mental health issues like mood changes, risky behaviors, social issues, and signs of substance abuse. For students with initial risk factors, the form recommends further psychological assessment and potential drug screening to confirm suspected drug addiction issues.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    277 views1 page

    General Health Profiling Students

    Uploaded by

    Mohammad Matte Ullah
    This document outlines a general health profiling form for public/private school students over 12 years of age in Chakwal District. The form collects basic personal and medical history information, including family history of illness, past medical issues, substance abuse history, and physical measurements. It also screens for mental health issues like mood changes, risky behaviors, social issues, and signs of substance abuse. For students with initial risk factors, the form recommends further psychological assessment and potential drug screening to confirm suspected drug addiction issues.

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    GENERAL HEALTH PROFILING FOR PUBLIC/PRIVATE SCHOOL STUDENTS (ABOVE 12 YEARS AGE) (DISTRICT CHAKWAL)

    Name of Institution: ___________________________________________ EMIS Code: _____________ Tehsil: ______________

    Part-A (Basic Personal Information)

    Name of Student: ___________________________________ CLASS/SECTION : _______________ Gender: _________Age: ______

    RESIDENTIAL ADDRESS . _________________________________________ Cell No.___________________

    Residential Address: ________________________________________________________________________________________

    Part-B (Basic Medical History)

    Sr. No. Indicator Yes No Detail if any

    1. Family History of any Medical or Psychiatric illness:

    2. Past medical and surgical history if any

    3. History of substance abuse in family (Drugs):

    4. Decrease appetite and loss of weight

    Part-C: (Overall General Physical Examination)

    Sr. No. Indicator Yes No Detail if any

    1. Height

    2. Weight

    3. Blood Pressure

    4. Temperature

    5. Pulse Rate

    6. Respiratory Rate

    7. Any obvious structural abnormality on inspection

    8. Any superficial cuts, needle marks, or burn marks on skin

    Part-D: 1. General Mental Health (as per Psychiatrist Assessment)

    Indicator good average poor

    1. General appearance and behavour

    2. Self care:

    3. Rapport building:

    4. Understanding of situation/response to instruction:

    2. General Mental Health (To be filled & authenticated by institution)

    Sr. No. Indicator Yes No Detail if any

    1. Past psychiatric history, if any

    2. History of smoking/substance abuse

    3. Decline in academic performance

    4. Risky behavior, vehicle accident, school fight, weapon possession

    5. Habit of running away/missing routine classes:

    6. History of stealing, late arrival in school, sexual activities

    7. Bad company, bullying, drug and scuffle:

    8. Isolation from positive interest/hobbies:

    9. Abrupt change in daily routine:

    10. Disturbed sleep/habit of dosing:

    11. Social media posts/other indications pointing towards drug use, tattoos, stickers on vehicle/books

    12. Mood swings/increased irritability

    13. Lack of physical energy and motivation, fatigue & tiredom

    14. Decline in self care:

    15. Suspiciousness or other unusual behavior:

    16. Decline in socialization:

    17. Unusual protective behavior/over secretive behavior

    18. Evidence of remains of cigarette/objects and tools used for drugs found in personal belonging:

    Part-E: (for positive initial risk assessment)

    ● Structured/formal psychological assessment to be carried out if there is sound susceptibility of substance use

    ● Use drug screening test if formal psychological assessment confirms suspicion of drug addiction.

    Signature of Teacher concerned Signature of Registered Medical Practitioner Signature of Head of Institution

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