Elena Goodwin

Please use blue or black ink when filling out this admission form. Additional information from all but the patient must be initialled by the author. Please answer all questions to the best of your ability. For further information or guidance, please contact a member of St. Christina staff at the number provided
in our guide brochure.

Patient Full Name: GOODWIN, ELENA

Age: 15
DOB: 05/19/1996
Gender: Female
Address: 2723 Cruickshank Rd
City: Phoenicia
State: NY
Ethnicity: Caucasian
Height: 5'
Weight: 112 lbs
Eye Color: Blue
Hair Color: Blonde
Distinguishing Marks: My flawless skin and perfectly straight and white teeth. I have no ugly birthmarks or anything that would tarnish my perfect looks in any way.


Medical History:

Please list any and all allergies and age of onset below:
I am allergic to cats, and I have been my whole life.

Are you aware of any ongoing medical issues?:
Not currently, but I had asthma when I was little. All the symptoms went away when we got rid of the cat.

If yes, list age of diagnoses by medical professionals, or age of onset below:
I was diagnosed with asthma when I was in elementary school, about age 6 or 7 I believe.

If you are receiving treatment for an ongoing medical complaint, please list prescriptions, strength of dose, frequency of dose, and other treatment plans below:
N/A

Do you smoke tobacco, consume alcohol, or use street drugs? If yes, please list number of packs per day, number of drinks per day and/or names of consumed drugs below:
N/A



Psychiatric History:

Have you been diagnosed with any psychiatric issues? If so, please list diagnoses and age of diagnoses below:
Apparently, I have narcissistic personality disorder. I think that's just what my aunt and uncle convinced a doctor to say so they could get rid of me.

If you answered yes to the above, please list any and all prescriptions, including dosage and frequency of dosage, and other treatment plans below:
Before Hadley, I was in therapy. Then, just whatever they were giving me at Hadley and more therapy.

If you answered yes to the above, please describe noted feelings, symptoms, triggers and incidents associated with the diagnoses, and ages of incidents below:
I don't like therapy, and the pills at Hadley were annoying. Why should I have to put chemicals in my system?

Have you ever been hospitalised for these diagnoses? If yes, please provide facility name(s) and age of admissions and discharges:
Yes, twice. I don't know the name of the hospital, my aunt would know that. I was 12, almost 13, the first time and it was for 3 days. My aunt decided that was necessary after her oldest daughter and I got into a fight. If the twit would have just stayed out of my way, her arm would have never been caught in the door. The second time, I was 14 and had to go to the hospital for a month. This time, it was court ordered because I accidentally set a church youth room on fire. No one believed that I didn't knock the candle over intentionally.

Are you aware of a history of psychiatric complaints in your family? If yes, please list family member(s), diagnoses, and how this affected you personally:
Nothing that I am aware of.



Environmental History:

Are you aware of any complications during your birth? If yes, please explain below:
There weren't any.

Are you aware of any difficulties in development during your infancy, such as learning disabilities, speech impediments, etc? If yes, please explain below:
No, I developed perfectly.

Are you aware of any long term separation from your mother during your infancy? If yes, please explain below:
No.

Please describe the location and environment in which you grew up. Please list town and state, and what it was like and how this affected you:
I grew up in Decatur, Georgia. It's a suburb of Atlanta. Everyone around town always said things like “Have a blessed day”, or crap like that. But mama and dad always told me they were too scared to admit that they were the only ones responsible for what happened in their lives. But even though most of the people were idiots, we had a nice, large house. Dad and mama made sure everything that we had was nice. They taught me to expect nice things, and that I would have them.

Please describe your educational history. How were you in school, both as a young child and in later grades? How were your grades? Did you enjoy school? Please answer below:
I was home schooled by a tutor until after my parents accident, when I had to go live with my aunt and uncle. I was the perfect student for the tutor. But my aunt and uncle said my parents had been spoiling me too much, and that I had to go to public school. It was awful. The kids were idiots, and the teachers had no business being around children. Eventually, the principal said it was best if I didn't come back. My aunt and uncle weren't happy about that, but I was. Until I wound up in Hadley. Apparently my aunt and uncle decided that was the best place for me.

Do/did you have many friends growing up? Do/did you have a best friend? If yes, please explain below:
I only associated with the kids my parents approved of. Mostly, at parties we would talk and be stuck in the same room together while our parents were in other rooms having fun. Sometimes, we would talk or hang out outside of the parties, but it was a bit rare. The girls were jealous of the attention that I got from the boys. And dad didn't want me to hang out with the boys outside the parties. Not like I thought any of them were good enough to keep my attention anyway. In public school, I had no use for any of the other kids. Same at Hadley.

Do/did you pursue any extra curricular activities or talents? If yes, please explain below:
I took piano lessons, vocal lessons, and dance lessons. I hated dance so I stopped taking those lessons, but I continued with piano and voice lessons until I had to go live with my uncle and aunt. I sing better than anyone I know, so my aunt will not let me continue with my lessons. She acts like anything enjoyable is a sin. I think she is jealous that her daughters are not as perfect as I am.

If sexually active, please list age of onset and sexual preference below. If not sexually active, are you aware of a sexual preference?:
I have not had sex. I haven't found any boy that I thought was good enough to give myself to. And the thought of having sex with a girl, well, it doesn't do anything for me. Besides, girls are always jealous of me, so why would I ever have do anything with someone who hated me for being better looking?



Legal History:

Do/did you ever abuse controlled substances, including but not limited to prescription medications, street drugs or alcohol? If yes, please explain below:
No

Have you ever been convicted of a crime? If yes, please list conviction, age of conviction and circumstances below:
Yes, apparently accidentally setting a church youth room on fire is grounds for arrest. No one believed that I accidentally knocked that candle over. I was just 14 when it happened. I was convicted of arson and reckless endangerment. 6 counts of endangering a child were dropped.

If you answered yes to the above, please list sentences connected to these convictions below:
I was forced to spend another month in a psych-ward. What a waste of my time. I was also put on probation until I turn 18, and I'm not allowed to get a driver's license until then.

Have you ever knowingly committed a crime for which you were not convicted or sentenced? If yes, please explain below:
No.



Personal Interview:

Describe yourself to the best of your ability in only five words:
The picture of absolute perfection.

Is the glass half empty, or half full? Explain your answer below:
Half full I guess. I have no explanation.

If you could change only one thing in your life, what would it be, and why?:
I'd make my parents accident never happen. Then, none of the rest of this crap would have happened.

How do you feel about your life and the things you have done in it, looking back? If you have committed crimes, how do you feel about those now?:
I think that if people would stop trying to force me to do things that I know are pointless, like going to church and sending me to public school, then I wouldn't have been in any of those situations. I feel like everything would be fine if people would just leave me be.

What are your goals in life, and how do you feel those would be best accomplished?:
I would like to get back to my life at some point, marry and all that. If I can ever find someone who is good enough to spend that much time with.

Lastly, why have you chosen admission at St. Christina Psychiatric Rehabilitation Center, and how do you think this will help you toward your life goals?:
I don't, really. But I was shipped here with everyone else from Hadley, and told to fill this thing out.



Patient/Guardian Signature:

By agreeing to admission to our facilities, you hereby agree to abide by all rules and terms of service outlined in patient or resident handbooks, rules and codes of conduct. You hereby agree to waive your right to voluntary dismissal from our facilities until such a time as facility administrators sign paperwork for your release. You hereby agree to comply with facility staff recommendations, demands, or outlines for treatment. You hereby waive your right to informed medical consent before medication changes or medical procedures. You hereby agree to waive your right to hold GR Biotech and its Subsidiaries responsible for any personal harm or distress incurred during treatment. GR Biotech and its Subsidiaries reserve the right to add or amend these terms of service at any time.

Please sign and date below:

Elena Goodwin 05/27/2011

Edited.

Welcome to St. Christina's Psychiatric Rehabilitation Center. Your ward and room assignments can be found below, along with the name of your primary therapist. Please familiarise yourself with all patient handbooks and codes of conduct.

Building: Bennett
Wing: N/A
Ward: B
Room: 2
Bed: 3
Primary Therapist: Dr. __________

OOC Information: All information below this line is not known by the patient, but is available on the patient's file, viewable only by staff.

Study Group(s):

Primary:Antisocial Behaviors

Final Application Approval Steps for Players:


Before you can begin play on STC, you must complete these final steps:

• Sign up your playby on the faceclaim.
  
• Sign up for the who plays who list.
  
• Sign up for your assigned membergroup (shown above) HERE (Pay close attention to pick the correct usergroup listed on this approval stamp! Characters that are not signed up for their correct membergroups after approval will be subject to deletion during the next activity check.)
  
• Familiarise Yourself with you Patient Hanbook, located in St. Christina's Rosters and Information forum, on the main board.

Code:

[center][font=garamond][size=22][color=#555555][b] -File Note- [/b][/color][/size][/font]

_____________________________________________________________[/center]

[b]Patient Name:[/b] Lastname, Firstname
[b]Primary Study Group:[/b] Issue Group Name
[b]Primary Therapist:[/b] Dr. ___________
[b]Building:[/b] Bennett/Robertson/Main
[b]Wing:[/b] Maine Building Only - Male/Female
[b]Ward:[/b] A/B/C

[center]_____________________________________________________________[/center]

[b]Note Subject:[/b] (Therapy Report, Medication Change, Dormitory Reassignment, Medical Report, Behavioural Report, Progress Report, Procedure Report, Disciplinary Report, etc.)

[b]Note Contents:[/b] (Explain behaviour observations, patient actions, procedures, medication changes, disciplinary actions, medical reports, etc. here)

[b]Note Author:[/b] (Your character name here.)

[b]Other:[/b] (Optional extra notes here.)