The following health care providers can perform initial examinations for PTSD.

a board-certified or board “eligible” psychiatrist;

a licensed doctorate-level psychologist;

a doctorate-level mental health provider under the close supervision of a board-certified or board eligible psychiatrist or licensed doctorate-level psychologist

a psychiatry resident under close supervision of a board certified or board eligible psychiatrist or licensed doctorate-level psychologist; or

a clinical or counseling psychologist completing a one-year internship or residency (for purposes of a doctorate-level degree) under close supervision of a board-certified or board eligible psychiatrist or licensed doctorate-level psychologist.

A. Identifying Information:

• age

• ethnic background

• era of military service

• reason for referral (original exam to establish PTSD diagnosis and related psychosocial impairment; re-evaluation of status of existing service-connected PTSD condition)

B. Sources of Information:

• records reviewed (C-file, DD-214, medical records, other documentation)

• review of social-industrial survey completed by social worker

• statements from collaterals

• administration of psychometric tests and questionnaires (identify here)

C. Review of Medical Records:

1. Past Medical History: