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Includes structured screening for nonmotor signs using UPDRS mental and mood domains (mentation/behavior, thought disorder, depression, motivation), plus other symptom prompts, driving safety status, and standardized medication reconciliation with allergies, vitals, and lab panels. Provides mental status examination fields, MOCA and MMSE scoring sections, optional neurologic exam elements, and a diagnostic impression/assessment area.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":36,"@type":70,"position":76},"https://docshare.wps.com/template/forms/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/geri-psych-clinic-templates-movement-disorder-psychiatry-clinic-new-consult/165879/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/geri-psych-clinic-templates-movement-disorder-psychiatry-clinic-new-consult/165879.png","ImageObject",442,249,{"name":88,"@type":89},"Jordan Avery","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/vnd.openxmlformats-officedocument.wordprocessingml.document","2026-09-27","2026-08-31",true,{"@type":98,"interactionType":99,"userInteractionCount":47},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What is the purpose of the Movement Disorders Psychiatric Consult template?","Question",{"text":108,"@type":109},"It is used to assess movement disorder–associated psychiatric symptoms in patients referred from a movement disorders clinic.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"Which UPDRS sections are included for mental and mood assessment?",{"text":113,"@type":109},"It includes intellectual impairment, thought disorder, depression, and motivation/initiative scoring.",{"name":115,"@type":106,"acceptedAnswer":116},"What cognitive screening tools and scoring areas are provided?",{"text":117,"@type":109},"The template includes MOCA dementia scale sections and MMSE scale items, along with word lists and memory tasks for further evaluation.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},165879,1790057972,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":35,"category_name":36,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":47,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":42,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":8},1099523882367,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Geri Psych Clinic Templates\nMovement Disorder Psychiatry Clinic NEW CONSULT\nMovement Disorders Psychiatric Consult\nPatient seen at the request of Movement Disorders Clinic to evaluate movement\ndisorder-associated psychiatric symptoms.\nID: |PATIENT AGE| yo |PATIENT SEX| with\n-----------------------------------------------------------------------\nS:\n----------------------------------------------------------------------------\nO:\nPRESENCE OF NONMOTOR SIGNS:\nUPDRS\nUNIFIED PARKINSON'S DISEASE RATING SCALE\nI. MENTATION, BEHAVIOR AND MOOD\n1. Intellectual Impairment\n0 = None.\n1 = Mild. Consistent forgetfulness with partial recollection of events and no\nother difficulties.\n2 = Moderate memory loss, with disorientation and moderate difficulty handling\ncomplex problems. Mild but definite\nimpairment of function at home with need of occasional prompting.\n3 = Severe memory loss with disorientation for time and often to place. Severe\nimpairment in handling problems.\n4 = Severe memory loss with orientation preserved to person only. Unable to make\njudgements or solve problems.\nRequires much help with personal care. Cannot be left alone at all.\n2. Thought Disorder (Due to dementia or drug intoxication)\n0 = None.\n1 = Vivid dreaming.\n2 = \"Benign\" hallucinations with insight retained.\n3 = Occasional to frequent hallucinations or delusions; without insight; could\ninterfere with daily activities.\n4 = Persistent hallucinations, delusions, or florrid psychosis. Not able to care\nfor self.\n3. Depression\n1 = Periods of sadness or guilt greater than normal, never sustained for days or\nweeks.\n2 = Sustained depression (1 week or more).\n3 = Sustained depression with vegetative symptoms (insomnia, anorexia, weight\nloss, loss of interest).\n4 = Sustained depression with vegetative symptoms and suicidal thoughts or\nintent.\n4. Motivation/Initiative\n0 = Normal.\n1 = Less assertive than usual; more passive.\n2 = Loss of initiative or disinterest in elective (nonroutine) activities.\n3 = Loss of initiative or disinterest in day to day (routine) activities.\n4 = Withdrawn, complete loss of motivation.\nOTHER:\n40. Does the patient have anorexia, nausea, or vomiting?\n0 = No\n1 = Yes\n41. Any sleep disturbances, such as insomnia or hypersomnolence?\n0 = No\n1 = Yes\n42. Does the patient have symptomatic orthostasis? ( Record the patient's blood\npressure, height and weight on the scoring form)\n0 = No\n1 = Yes\nDRIVING SAFETY STATUS:\n---------------------------------------------------------------------------\nPAST MEDICAL HISTORY:\n|ACTIVE PROB LIST-SHORT|\nOUTPATIENT MEDICATIONS:\n|ACTIVE OUTPATIENT MEDICATIONS|\nMEDICATIONS RECONCILIATION:\nI have reviewed the patient's outpatient medications with\nthe patient or caregiver and the list above accurately\nreflects the medications that the patient is currently\ntaking including any that may be provided from non-VA\nsources, over the counter medications, nutritional or\nother supplements.\nOR:\nMEDICATIONS RECONCILIATION:\nThe patient and/or his/her caretaker were unable to participate in the\nmedication reconciliation at this time due to:\nHowever, I have reviewed the patient's outpatient medication list\non record.\nALLERGIES: |ALLERGIES/ADR|\nVITAL SIGNS:\n|VITALS-LAST|\nLABORATORY DATA:\nTSH: |LR TSH NEW|\nFree T4: |HSO FREE T4|\nVit D: |LR 25-VITD|\nB12: |LR VIT B12|\nFolate: |LR FOLATE|\nMMA  |LR MMA SERUM|\nThiamine B1 |LR VIT B1|\nRPR: |LR RPR|\nCD4: |LR CD4+/3+ LY(T-4) #|\nHIV VL: |LR HIV PCR ULTRA SENSITIVE|\nRBC: |LR RBC|\nHgb: |LR HEMOGLOBIN|\nHct: |LR HEMATOCRIT|\nMCV: |LR MCV|\nMCH: |LR MCH|\nMCHC: |LR MCHC|\nWBC: |LR WBC|\nRDW: |LR RDW|\nNeutrophil: |NEUTROPHIL # (AUTO)|\nPlatelet: |LR PLATELET COUNT|\nLDL: |LR LDL CHOLESTEROL, CALCULATED (WLA)|\nHDL: |LR HDL CHOLESTEROL-WLA|\nTG: |LR TRIGLYCERIDE-WLA|\nTot cholesterol: |LR CHOLESTEROL|\nA1c: |LR HGBA1C 3,2|\nNa: |LR SODIUM|\nK: |LR POTASSIUM|\nGLU: |LR GLUCOSE|\nBUN: |LR UREA NITROGEN|\nCREAT: |LR CREATININE|\nCREAT IDMS: |LR CREATININE IDMS|\nCO2: |LR CO2|\nCC: |LR CREATININE CLEARANCE|\nUrine C&S: |HSO URINE C&S|\nUrine Tox","cbCaig2HMH1RRODc","https://ap.wps.com/l/cbCaig2HMH1RRODc","docx",68935,"English","# Movement Disorders Psychiatric Consult\n## UPDRS - Mentation, Behavior and Mood\n## Other - Nonmotor Symptom Prompts\n## Driving Safety Status\n## Medication Reconciliation and Allergies\n## Vitals and Laboratory Data\n## Mental Status Examination\n## MOCA Dementia Scale\n## MMSE Scale\n## Word Lists and Memory Tasks\n## Neurologic Exam (Optional)\n## Diagnostic Impression/Assessment","[{\"question\":\"What is the purpose of the Movement Disorders Psychiatric Consult template?\",\"answer\":\"It is used to assess movement disorder–associated psychiatric symptoms in patients referred from a movement disorders clinic.\"},{\"question\":\"Which UPDRS sections are included for mental and mood assessment?\",\"answer\":\"It includes intellectual impairment, thought disorder, depression, and motivation/initiative scoring.\"},{\"question\":\"What cognitive screening tools and scoring areas are provided?\",\"answer\":\"The template includes MOCA dementia scale sections and MMSE scale items, along with word lists and memory tasks for further evaluation.\"}]","Geri Psych Clinic Templates - Movement Disorder Psychiatry Clinic - NEW CONSULT | DOCX",1788178052]