<?xml version="1.0" encoding="UTF-8" standalone="no"?> <?xml-stylesheet type="text/xsl" href="http://r.kareo.com/resources/ehr/ccda/stylesheet/ccda-html.xsl"?> Eileen Long MSW LCSW: Health Summary 3932 Scarbough Way Jefferson City MO 65109 OLIVIA GRAY Eileen Long MSW LCSW 1714 Oak Cliff PL Columbia MO 65203-4719 1714 Oak Cliff PL Columbia MO 65203-4719 Eileen Long 1714 Oak Cliff PL Columbia MO 65203-4719 Eileen Long Eileen Long MSW LCSW 1714 Oak Cliff PL Columbia MO 65203-4719 Eileen Long Eileen Long MSW LCSW 1714 Oak Cliff PL Columbia MO 65203-4719 Eileen Long

PROBLEMS
Problem Effective Dates Problem Status
No information about problems
SOCIAL HISTORY
Social History Element Description Effective Dates
No Information About Social History
INSTRUCTIONS No Information About Instructions
MENTAL/FUNCTIONAL STATUS
Mental/Functional Findings
No Information Available
ADVERSE REACTIONS, ALERTS, ALLERGIES
Type Substance Reaction Severity Status
No information about allergies
ENCOUNTERS
Encounter Diagnosis Performer Date Status
No information about encounters
Plan Of Care
Problem Care Plan
Chief Complaint
Reason for Visit/Chief Complaint
PROCEDURES
Name Related To Date
No Information About Procedures
MEDICATIONS
Medication Start Date Instructions Status
No medications information available
VITAL SIGNS No Information About Vital Signs #vitalsigns1
RESULTS
Name Actual Result Date Laboratory
No Information About Results
IMMUNIZATIONS
Vaccine Name Date Status
No immunization information available
Medical Devices
GMDN Name UDI Expiration Date Status
No Information available for Medical Equipment.
ASSESSMENTS
ASSESSMENTS

Time: 12:30 - 1:20 PM M Olivia, Chase, Noah, and Kate participated during the session. SW provided mindfulness activities to teach ways the family can help control anxiety and cope with stress. After the session, they reported feeling relaxed and calm.



Kate-Katherine Elizabeth Gray 4-19-2012

Noah-Noah Alexander Gray 2-11-2008

Chase-Charles Robert Gray 5-12-2005

Father: Charles Brockman Gray -3-27-1975

Address: 732 10th Calvary Loop
Fort Leavenworth, KS. 66027
Phone: 417-848-2415


Mother: Oliva Susan Gray 12-27-1977

828 Weathered Rock Court Apt # 1
Jefferson City, MO. 65101
Phone; 573-418-2390

10:00-10:45 am Family meeting with the three children.

The children are visiting their mother until July 2nd when they will return to their father for the 4 day 4th of July holiday. They have participated in therapy with their mother for several sessions.

Kate disclosed the following information:
"Daddy spanks me hard I get in trouble a lot." "I am afraid of him sometimes when he is drinking because he gets so mad at me." "He gets mad whenever I fight with my brothers he always blames me even if I didn't do anything." " I kissed Liam so that he would like me because he said he wouldn't be my friend if I didn't let him."

Chase shared his perspective. "I worry all the time about my little sister, sometimes my dad gets so angry at her and he takes her in another room and yells, then we hear a hard slap." " She is crying and upset for a long time after that." My sister is not safe, none of us feel safe at our dad's house. "We love our dad but I worry about Kate what will happen to her, Dad hurts her."

Noah was too upset to say much of anything but he did validate what Chase shared concerning his father. Noah stated, "I do not feel safe at dad's home and I worry about Kate too."
Reason For Referral
Reason For Referral

Time: 12:30 - 1:20 PM M Olivia, Chase, Noah, and Kate participated during the session. SW provided mindfulness activities to teach ways the family can help control anxiety and cope with stress. After the session, they reported feeling relaxed and calm.



Kate-Katherine Elizabeth Gray 4-19-2012

Noah-Noah Alexander Gray 2-11-2008

Chase-Charles Robert Gray 5-12-2005

Father: Charles Brockman Gray -3-27-1975

Address: 732 10th Calvary Loop
Fort Leavenworth, KS. 66027
Phone: 417-848-2415


Mother: Oliva Susan Gray 12-27-1977

828 Weathered Rock Court Apt # 1
Jefferson City, MO. 65101
Phone; 573-418-2390

10:00-10:45 am Family meeting with the three children.

The children are visiting their mother until July 2nd when they will return to their father for the 4 day 4th of July holiday. They have participated in therapy with their mother for several sessions.

Kate disclosed the following information:
"Daddy spanks me hard I get in trouble a lot." "I am afraid of him sometimes when he is drinking because he gets so mad at me." "He gets mad whenever I fight with my brothers he always blames me even if I didn't do anything." " I kissed Liam so that he would like me because he said he wouldn't be my friend if I didn't let him."

Chase shared his perspective. "I worry all the time about my little sister, sometimes my dad gets so angry at her and he takes her in another room and yells, then we hear a hard slap." " She is crying and upset for a long time after that." My sister is not safe, none of us feel safe at our dad's house. "We love our dad but I worry about Kate what will happen to her, Dad hurts her."

Noah was too upset to say much of anything but he did validate what Chase shared concerning his father. Noah stated, "I do not feel safe at dad's home and I worry about Kate too."
Goals
Goals
No Information Available
Health Concerns
Health Concerns
No Information Available