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Public Psychological Services 10/29/2019
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Last modified
10/17/2024 2:37:20 PM
Creation date
11/12/2019 10:33:51 AM
Metadata
Fields
Template:
Contracts
Contractor's Name
Public Psychological Services
Approval Date
10/29/2019
Department
Fire
Department Project Manager
Dave DeMarco
Subject / Project Title
Pre Employment Psychological Evaluation
Tracking Number
0002045
Total Compensation
$65,000.00
Contract Type
Agreement
Contract Subtype
Professional Services
Retention Period
6 Years Then Destroy
Document Relationships
LEPS/PSS PLLC dba Public Psychological Services 10/14/2024 Amendment 4
(Contract)
Path:
\Records\City Clerk\Contracts\6 Years Then Destroy\2025
Public Psychological Services 10/8/2021 Amendment 1
(Contract)
Path:
\Records\City Clerk\Contracts\6 Years Then Destroy\2022
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H22. Have you ever tried, used, or experimented with cocaine? <br /> a. No <br /> b. Yes • <br /> IF YOU ANSWERED"NO",SKIP TO QUESTION H27. <br /> IF YOU ANSWERED''YES",CONTINUE WITH QUESTION H23, <br /> H23. During your entire life, how often have you tried, used, or experimented with <br /> cocaine?(WHEN ESTIMATING YOUR TOTAL COCAINE USE, REMEMBER THAT ONCE A <br /> MONTH FOR A YEAR IS 12 TIMES,AND ONCE A WEEK FOR A YEAR IS ABOUT 50 TIMES.) <br /> a. 1-2 times <br /> b. 3-5 times <br /> c. 6-10 times <br /> d. 11-20 times <br /> e. 21-50 times <br /> f. More than 50 times <br /> H24. How old were you when you first tried, used, or experimented with cocaine? <br /> a. 12 or younger <br /> b. 13-17 <br /> c. 18-20 <br /> d. 21 or older <br /> H25. When was the last time you tried, used, or experimented with cocaine? <br /> a. In the last week <br /> b. Between 2 and 4 weeks ago <br /> c. Between 1 and 3 months ago <br /> d. Between 4 and 12 months ago <br /> e. Between 1 and 2 years ago <br /> f. 3 or more years ago <br /> H26. During the last 12 months, how often have you tried, used, or experimented with <br /> cocaine? <br /> a. Never <br /> b. 1-2 times <br /> c. 3-5 times <br /> d. 6-10 times <br /> e. 11-20 times <br /> f. 21-50 times <br /> g. More than 50 times <br /> H27. Have you ever tried, used, or experimented with crack(rock cocaine)? <br /> a. No <br /> b. Yes <br /> PSS/LEPS PLLC 80 <br />
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