Screening Questionnaire definition
Examples of Screening Questionnaire in a sentence
The Screening Questionnaire will be available on the Settlement Website, through a link maintained on the NCAA’s website to the Settlement Website, or upon request from a Settlement Class Member to the Program Administrator through regular mail.
Although the primary purpose of the Screening Questionnaire is to determine who will qualify for a Medical Evaluation, evidence of potential suicidality may warrant immediate evaluation and possible intervention prior to the Medical Evaluation visit.
Class Members who wish to participate in the Medical Monitoring Program must complete a Screening Questionnaire to determine whether they qualify for a Medical Evaluation.
The Screening Questionnaire may be completed in hard copy or online.
If a Settlement Class Member is not able to complete the Screening Questionnaire unassisted, a family member or other authorized designee may complete the Screening Questionnaire, noting his or her identity on the Screening Questionnaire.
If a Settlement Class Member provides responses to mood-related questions on the Screening Questionnaire that reach a specific threshold for suicide potential (as determined a priori by the Medical Science Committee), the identity of the Settlement Class Member will be provided to a trained clinician (e.g., clinical social worker) at the nearest Program Location.
The Medical Science Committee can suggest changes to the Screening Questionnaire that are consistent with changes to the standard of care for the diagnosis and treatment of concussions and problems or disorders related to concussions or the accumulation of subconcussive hits.
The Medical Science Committee will promptly report any changes to the Screening Questionnaire to Class Counsel, the NCAA and Counsel for the NCAA and will report any such changes to the Court on an annual basis.
A Settlement Class Member may complete a Screening Questionnaire not more than once every five (5) years until the age of 50 and then not more than once every two (2) years after the age of 50, unless otherwise permitted on a case-by-case basis by the Medical Science Committee.
The County and the Sheriff will ensure that the 14 Medical/Mental Health Screening Questionnaire, the Arrestee Medical Screening 15 Form (SH-R-422) or its equivalent, and/or the Confidential Medical Mental Health 16 Transfer Form are in the prisoner’s electronic medical record or otherwise 17 available at the time the prisoner is initially assessed by a QMHP.