Sophie-Rosaline St.John

by Guest Mon May 16, 2011 2:38 am

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-Patient Admission Form-

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.

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Sophie-Rosaline St.John Emily-browning-20051005-75869

Patient Full Name: ST.JOHN, SOPHIE-ROSALINE

Age: 17
DOB: 11/08/1993
Gender: Female
Address: The Hadley Institute, 2723 Cruickshank Rd
City: Phoenicia
State: New York
Ethnicity: Southern American
Height: 5'4
Weight: 140...?
Eye Color:Hazely
Hair Color:Brownish.
Distinguishing Marks: Freckily and pale.

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Medical History:

Please list any and all allergies and age of onset below:
Dust, Pollen, Animals, Mold, and since forever. Grade school, I would guess.

Are you aware of any ongoing medical issues?:
Nopes

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

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

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:
Ew, no, and ew.

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Psychiatric History:

Have you been diagnosed with any psychiatric issues? If so, please list diagnoses and age of diagnoses below:
According to what people told me at Hadley, I've got some big bad issue with OCD, and some pretty general anxiety issues. My old doctor thought I had oral fixation issues cause I suck my thumb all the time, but I dunno. I had been seeing her for a couple years prior to Hadley.

If you answered yes to the above, please list any and all prescriptions, including dosage and frequency of dosage, and other treatment plans below:
Okay, so, I was on Zyrtec everyday for allergies, but I dunno what I've been on since I left home. Other than that, I don't know. Mom and Dad never made me take medication, but Hadley was all about it. I was on one thing that made me high as a kite, but they changed that, and I've been pretty good ever sense. As for other treatment plans, I've been trying to conquer a lot of my fears on my own time, but with little success and lots of panic attacks.

If you answered yes to the above, please describe noted feelings, symptoms, triggers and incidents associated with the diagnoses, and ages of incidents below:
Well, the librarians can attest to my OCD. I'm in the library every day, keeping their books in order, cause it's the only place they'll let me organize. It's relaxing, honestly. I can go there with my blanket and suck my thumb while I shelves books single handedly, and it's like everything rights itself while I'm not paying attention. I don't really know what triggers my panic attacks, but I do know that sucking my thumb or organizing things helps keep me from having one. Once they get going though... I dunno how to stop them. They're just this never ending cycle of illogical idiocy. I guess I just eventually lose the energy to keep the panic going. OH! I do know one trigger for the worst panic attack ever: having my blanket stolen from me. Just, FYI.

Have you ever been hospitalized for these diagnoses? If yes, please provide facility name(s) and age of admissions and discharges:
Besides Hadley? No. I never did anything that hurt anyone.

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:
Not that I remember...

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Environmental History:

Are you aware of any complications during your birth? If yes, please explain below:
Mom said that I took my sweet time coming, but once I started, I was ready to get it all over with.

Are you aware of any difficulties in development during your infancy, such as learning disabilities, speech impediments, etc? If yes, please explain below:
Mom said that she should have waited a few years in teaching me how to talk, cause I never stopped. I bet that made life difficult.

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

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 the Lafayette/Carencro area, in a pretty neighborhood with a park and a daycare and stuff. I lived there my whole life, but I don't think you wanna hear all that, so to sum it all up, life was good. I mean, my sister was a devil who picked on me and beat me up a lot, but that's just cause she thinks I'm crazy. Once she moved out and went to college though, life was really really epic.

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:
As a kid I was a straight A student, but once I started going to a school for 'smart kids' I kinda just quit caring. My parents knew I was smart, I knew I was smart, but I just didn't care anymore. Why try and prove to an endless supply of people that I'm good? I know, and that's all that matters.

Do/did you have many friends growing up? Do/did you have a best friend? If yes, please explain below:
Up until we split apart at 9th grade, I had two best friends, Sarah and Roberta. We used to keep in touch online, but I haven't heard from them since I went to Hadley. My parents wrote me once, said that they were asking for me. But, yeah. they were awesome girls. Sarah was really big into the gothic vampire stuff, and Roberta was into music and band. And cats. They were the best, cause they never made fun of me in a mean way, and they always stood up for me when people made fun of me about my blanket. Once, Sarah even bit a guy who was looking like he was gonna steal my blanket off me. Best Friends ever.

Do/did you pursue any extra curricular activities or talents? If yes, please explain below:
I played softball for a few years, but I couldn't really handle the game. Too hot, too much outside, and too many bruises. Oh, and I can't catch anything, and I was too scared to swing the bat, ect.ect. It was ridiculous, but fun.

If sexually active, please list age of onset and sexual preference below. If not sexually active, are you aware of a sexual preference?:
Sex is meh. I mean, guys are cute and everything, but the idea of sex just doesn't really cross my mind. I've been 'interested' in boys since second grade, i think. But, I've totally still got my V card, no worries there. I wouldn't say I'm bi, but I'm not gonna knock the idea until I've tried it.

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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:
Eugh, no. I had champagne once, and it was gross, and I don't care about any of those other things.

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

If you answered yes to the above, please list sentences connected to these convictions below:
So, I know my mom wrote about this one time on my last application, but it wasn't a convicted crime. I remember she wrote it though, so it's probably important, so here we go: I went to go spend the night at my friend Mari's house, and we got locked out, and a bunch of stupid stuff happened, and by midnight, I just wanted to go home, so this guy she knew was gonna give me a ride home. I don't really remember what happened, but mom says that the cops found me with some blood on me, and I was 'non-responsive' or something. Apparently, I quoted a movie and said "Guy killed me, Mal. He killed me with a sword. How weird is that?" and didn't say much else until the next day, when mom tried to ask me what happened. She says that I said that there was a party and I didn't want to be there and wanted to go home. I have no clue what that was about, cause I don't remember any party.

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

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Personal Interview:

Describe yourself to the best of your ability in only five words:
Linus. Curious. Scared. Sarcastic. Shy.

Is the glass half empty, or half full? Explain your answer below:
Honestly, I hate this question, cause I always want to say that there is no glass, and no matter how full it may or may not have been, it makes the same amount of mess all over the floor.

If you could change only one thing in your life, what would it be, and why?:
I wouldn't change a thing, even the sucky parts. Cause, everything turns out great in the end. The bad things are just lessons, lessons that we may take years to uncover and understand, and I would never go back and erase them, because to do that, would erase the lessons I learned, and the memories I gained.

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 feel bad that my anxiety keeps me from doing a lot of things, and I'm kind of scared about what it will keep me from doing in the future, but I'm trying to be upbeat about it all.

What are your goals in life, and how do you feel those would be best accomplished?:
I don't have any. I guess I want to graduate school, and I know my mom's going to force me to go to college, but I don't really have any personal plans.

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?:
Well they kind of handed me this application to fill out, and I don't know if I have a choice or not, but my parents want me to get better, and this is supposed to be the best place to do it.

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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:

Terance Hamilton, Hadley Staff

by Guest Tue May 17, 2011 1:02 am

-Pending-
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This application is currently pending. Below, you'll find the reasons for this pending notice. If you wish to continue the application process, please follow the points laid out below by a member of STC's staff.

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The address listed isn't current. Since she is relocating from Hadley, she should have Hadley's address listed.
Don't forget that the application is written. It's unlikely that a person would write out words like "um" in a written application.
The answer to the last question in the legal history section is unacceptable. If she's done something, she has to explain it.

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Please reply to this thread once you have edited your application, to let us know, and a member of STC's staff will review your application again at our next possible convenience..

by Guest Tue May 17, 2011 9:00 pm

Fixed!

by **Admin Space** Wed May 18, 2011 9:22 pm

_____________________________________________________________
-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.

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Building: Bennett
Ward: C
Room: 1
Bed: 2
Primary Therapist: Dr. __________

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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.

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Study Group(s):

Psychiatric Issues

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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.

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FILE NOTE
-For St. Christina's Staff Use Only-

Code:: [center][font=garamond][size=22][color=#555555][b] -File Note- [/b][/color][/size][/font] _____________________________________________________________[/center] [b]Patient Name:[/b] St.John, Sophie-Rosaline [b]Primary Study Group:[/b] Psychiatric Issues [b]Primary Therapist:[/b] Dr. ___________ [b]Building:[/b] Bennett [b]Ward:[/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.)

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