Psychosis/Schizophrenia Questionnaire/Assessment Tool Patient Name *Phone Number *Email Address *1. Do you ever hear or see things that others cannot? *NeverRarelySometimesOftenVery Often2. Do you struggle to trust that what you are thinking is real? *NeverRarelySometimesOftenVery Often3. Do you get the sense that others are controlling your thoughts and emotions? *NeverRarelySometimesOftenVery Often4. Do you struggle to keep up with daily living tasks such as showering, changing clothes, paying bills, cleaning, cooking, etc.? *NeverRarelySometimesOftenVery Often5. Do you feel that you have powers that other people cannot understand or appreciate? *NeverRarelySometimesOftenVery Often6. Do you find it difficult to organize or keep track of your thinking? *NeverRarelySometimesOftenVery Often7. Do other people say that it is difficult for you to stay on subject or for them to understand you? *NeverRarelySometimesOftenVery Often8. Are you struggling with maintaining social relationships, employment, and/or academic demands? *NeverRarelySometimesOftenVery Often9. Do you feel that you are being tracked, followed, or watched at home or outside? *NeverRarelySometimesOftenVery Often10. Do other people have a difficult time guessing your emotions by your facial expressions? *NeverRarelySometimesOftenVery Often Submit
