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Lily Walden

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Lily Walden Empty Lily Walden

Post by Guest on Thu Jul 28, 2011 12:01 am

Lily Walden Stchristinaslogobase
-Patient Admission Form-

Please use blue or black ink when filling out this admission form. Additional information from all but the patient must be initialed 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.


Lily Walden Rt26i0

Patient Full Name: Walden, Lily

Age: 13
DOB: 9/1/1997
Gender: Female
Address: 192 Seaside Lane
City: Lake Bluff
State: Illinois
Ethnicity: Caucasian
Height: 5’ 2”
Weight: 100 lbs.
Eye Color:blue
Hair Color:blonde
Distinguishing Marks: I have pierced ears and several cigarette burns on my inner thighs, all self inflicted.


Medical History:

Please list any and all allergies and age of onset below:


Are you aware of any ongoing medical issues?:


If yes, list age of diagnoses by medical professionals, or age of onset below:


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


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:



Psychiatric History:

Have you been diagnosed with any psychiatric issues? If so, please list diagnoses and age of diagnoses below:

pyromania – age 11
minor obsessive compulsive tendencies – age 9

If you answered yes to the above, please list any and all prescriptions, including dosage and frequency of dosage, and other treatment plans below:

Prozac – 20 mg per day

If you answered yes to the above, please describe your feelings, symptoms, triggers and any incidents associated with the diagnoses, such as outbursts, suicide attempts or any other signs of non-typical behaviors, and approximate ages of incidents below:

When I need to burn something, I get this sort of itching in my fingers. It starts out small, then it gets stronger and stronger until I can’t take it anymore. It’s defiantly a need, not a want. I’m not exactly sure what triggers it, it’s kind of just always there.

I try to control it. I know I’m not supposed to burn things, but it just feels so good. It’s the best kind of release you could imagine. It truly amazes me how powerful flames can be, how they can completely cleanse everything.

Sometimes I can hold it off. Sometimes just imagining burning something is enough, or sometimes I can just light matches without actually catching something on fire. But God, when you actually do light something up? Infinitely better.

My aunt and uncle don’t like me burning things, so when they catch me they get really mad. I don’t commit arson or anything, though. I just burn my own stuff, or trash sometimes. It’s mostly useless junk, anyway. It’s not like I’m using houses to get my fix.

I got my cousin Jenna in on it, though, and that’s what set them off. She’s only seven, so she just tags along with me. She thinks it’s cool, but not the way I do. One time, though, she got kind of burn. Not bad, I didn’t let anything bad happen to her. They decided to kick me out then, though.

Have you ever been hospitalized for these diagnoses? If yes, please provide facility name(s) and age of admissions and discharges as well as what diagnoses you were you hospitalized for, or what incidents lead to hospitalization:

No. My aunt and uncle sent me to a therapist when I first came to live with them, who deicide I had minor OCD. Then, a few years later, they caught me setting things on fire in my wastebasket, so they sent me back and decided I was a pyromaniac. I’ve never been hospitalized for either disorder, though.

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:



Environmental History:

Are you aware of any complications during your birth? If yes, please explain below:


Are you aware of any difficulties in development during your infancy, such as learning disabilities, speech impediments, etc? If yes, please explain below:


Are you aware of any long term separation from your mother during your infancy? If yes, please explain below:

My mother disappeared for periods of time when I was living with her. I’m not sure how early she starting leaving me, though. Maybe two or three?

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 with my mother in Chicago, Illinois. We moved around a lot, but stayed in the same general area. My mom was good at getting us evicted. When I was younger, it was just her and I. She disappeared a lot, but only for a day or two. I was able to take care of myself fine for a few days, but not for much longer.

When I was about six, though, she met Mike. They started leaving more frequently then, and for longer periods. By that time I was old enough to take care of myself.

When they were home, they mostly left me alone. They were usually high or drunk, and they just got in the way. I’d rather they left me alone. Mike touched me sometimes, but never around Mom. I’m not sure if she would’ve stopped him. He never raped me, but he touched me enough to make me feel dirty.

The first time he touched me I was about seven. I tried to clean myself in the tub, but I just didn’t feel clean enough. I burned myself with some cigarette butts around where he touched me, and that fixed it. That’s when I really started getting into fire.

When I was nine, Mom and Mike didn’t come back. I held out for a long time on my own. I was doing fine, but the school started to investigate. They took me away and sent me to live with my aunt and uncle. They’re alright, but mostly they just get in my way.

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? What was school socialization like? What were your academic strengths and weaknesses? Please answer below:

I never liked school, I mainly just stayed to myself. I didn’t really bother with doing my work. I liked reading, but not the stuff they suggested.

Do/did you have many friends growing up? Do/did you have a best friend? If yes, please explain below:

When I was with Mom, I didn’t have any friends. I liked to stay at home. At my aunt and uncle’s, I made friends with Jenna, who I guess is my best friend.

Do/did you pursue any extra curricular activities or talents? If yes, please explain below:

Like I said, I like to read.

If sexually active, please list age of onset and sexual preference below. If not sexually active, are you aware of a sexual preference?:

I am not sexually active, though I am straight.

Please explain a little about your overall life below. What circumstances do you feel have brought you to where you are now? How do you feel about those? Do you have any thing else to note about your life that you feel has had some bearing on your current situation? Please explain below:

I’ve already explained my life.

Lily came to our house when she was nine. We were more than happy to take her in. She started to show alarming signs, however. She shows very little emotion, and is detached about things that she should be more emotional about. Lily is also determined to retain total control, going so far as exploiting other’s weaknesses.

Her pyromania, however, was what really disturbed us. She started starting small fires when she first came to live with us. She told us that she hadn’t started fires previously, but had only played with matches and the likes.

Over the years, her fires have grown. She began pressuring our daughter into joining her, and put her in danger countless times. The particular incident that forced us to remove her from our home occurred when she set a trashcan on fire. Something in the trashcan shot out and burned our daughter’s arm. It wasn’t serious, but we realized Lily could no longer remain in our home. – Arnold Walden (Lily’s uncle)


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. I’ve tried alcohol before, but never had a taste for it.

Have you ever been convicted of a crime? If yes, please list conviction, age of conviction and circumstances below:

No. I’m not an arsonist. I don’t hurt anyone.

If you answered yes to the above, please list sentences connected to these convictions below:


Have you ever knowingly committed a crime for which you were not convicted or sentenced? If yes, please explain below:



Personal Interview:

Describe yourself to the best of your ability in only five words:

I am a teenaged girl.

You come across a glass of water. The total volume of water in the glass constitutes half of its total capacity. Is the glass half empty, or half full? Explain your answer below:

It’s half full, because that’s the way that people talk.

I’m not going to play into these stupid psychological games.

If you could change only one thing in your life, what would it be, and why?:

I would like to have longer hair.

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’m not crazy about it, but it could have been worse.

What are your goals in life, and how do you feel those would be best accomplished?:

I want to be left alone.

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’m being kicked out of my house.


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:

    Lily Walden 07/27/2011
    Arnold Walden 07/27/2011

St. Christina Psychiatric Rehabilitation Center & St. Christina Medical Center are Subsidiaries of GR Biotech. All rights reserved ® 2011

Player Nickname:Lola
Chatango Screename:Lolasauce
Character Play-ByDakota Fanning


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Lily Walden Empty Re: Lily Walden

Post by Admin Space on Thu Jul 28, 2011 5:39 pm

Lily Walden Stchristinaslogobase
-Patient Admission Approved-

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: C
Room: 5
Bed: 2
Primary Therapist: Dr. Bamidele Wynn

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 Behaviours


Final Application Approval Steps for Players:

Your assigned membergroup is: Adolescent Patient

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.

-For St. Christina's Staff Use Only-

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


[b]Patient Name:[/b] Walden, Lily
[b]Primary Study Group:[/b] Antisocial Behaviours
[b]Primary Therapist:[/b] Dr. Bamidele Wynn
[b]Building:[/b] Bennett
[b]Wing:[/b] N/A
[b]Ward:[/b] C


[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.)

This app was reviewed by: Admin Space and Admin Ghost.


Admin Space
Admin Space

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