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The Georgia Cold Case Project

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Severity (Mild, Moderate, Severe)

Sexual Assault

Mental Health

Behavioral

Emotional

Developmental Delays

Learning

Child Characteristics

60. Yes

Does the child have any known issues, disabilities or special needs?

No

If yes, please describe the issues below:

Issue Medical/physical

Description

61. _____ _____

What type of services is the child currently receiving?

Psychological counseling

Learning disability counseling

_____ _____

Psychiatric treatment

Medical treatment

_____ _____

Tutoring O t h e r : _ _ _____ Independent Living services _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

62.

How many child psychological/psychiatric assessments are in the file?

_________________

63.

Date of earliest psychological assessment in the file:

_____ /_____ /_____

(please complete the Earliest Psychological Assessment Review Form)

64.

Date of most recent psychological assessment in the file:

_____ /_____ /_____

(please complete the Most Recent Psychological Assessment Review Form)

65.

Has the child had any juvenile delinquency involvement (include prior to and during DCFS care)?

I f y e s , p l e a s e d e s c r i b e : _ _ _ _ _ _ _ _ Yes No _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

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