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Psychological History Report
<br /> Anger,Problems (555-66-7779) 29-Nov-01
<br /> Adult Relationships
<br /> Currently lives
<br /> => with spouse. (K1,b,36%,100%)(0)
<br /> => with adult roommate(s). (K1,e,11%,100%)(0)
<br /> Is legally married. (K2,b,36%,100%)(0)
<br /> Has been married once. (K3,b,39%,100%)(0)
<br /> Describe your first marriage:
<br /> Your age at the time you were married
<br /> Your mate's age at that time
<br /> The number of years you have been married
<br /> The number of children produced by that marriage
<br /> Has not ever been separated, during his current marriage. (K4,a,94%,100%)(0)
<br /> • His current marital or romantic relationship is'very unsatisfactory: (K5,e,2%,2%)(2)
<br /> => Has had conflicts in personal relationships, but they have not interfered with his job performance.
<br /> (K6,b,47%,49%)(0)
<br /> => Has never slapped or punched a spouse or romantic partner. (K7,a,95%,100%)(0)
<br /> Has not slapped or punched a spouse or romantic partner in the last 3 years. (K8,a,99%,100%)(0)
<br /> • His spouse or romantic partner has hit him on one occasion. (K9,b,7%,12%)(1)
<br /> => During the last 3 years, his spouse or romantic partner has never slapped, punched, or otherwise struck or
<br /> injured him. (K10,a,96%,100%)(0)
<br /> Police have never responded to his home because of a domestic disturbance that involved him.
<br /> (K11,a,94%,100%)(0)
<br /> => Has never committed, or been accused of committing, threats of physical harm, or stalking, directed at a
<br /> spouse or romantic partner. (K12,a,99%,100%)(0)
<br /> => During the last 3 years, has never committed, or been accused of committing,threats of physical harm,or
<br /> stalking, directed at a spouse or romantic partner. (K13,a,99%,100%)(0)
<br /> => Has never been named in a legal restraining order for behavior that threatened others. (K14,a,98%,100%)(0)
<br /> Parental Responsibilities
<br /> Has no children living with him. (L1,a,62%,100%)(0)
<br /> _> Does not have any biological children. (L2,a,60%,100%)(0)
<br /> Is not currently delinquent with any child support obligations. (L3,a,99%,100%)(0)
<br /> Has never failed to make child support payments. (L4,a,98%,100%)(0)
<br /> Has no biological children under age 18, or children that do not live with him. (L5,a,91%,100%)(0)
<br /> Neither he nor his spouse nor any other custodian of his children has ever disciplined them such as to
<br /> produce red marks, welts, or bruises. (L6,a,98%,100%)(0)
<br /> =>Verify with applicant . Serious admission .•Conditional DQ admission .. Unconditional DQ admission ??Unanswered
<br /> 7/312S fLEPS PLLC PsyQ_190520 44
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