[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-1-en-105":3,"doc-seo-166766-105":53,"doc-detail-166766-en":126},{"code":4,"msg":5,"data":6},0,"success",[7,14,19,24,29,34,39,44,49],{"id":8,"doc_module":9,"doc_module_name":10,"category_name":11,"show_sort_weight":12,"slug":13},11,1,"Template","Presentations",90,"presentations",{"id":15,"doc_module":9,"doc_module_name":10,"category_name":16,"show_sort_weight":17,"slug":18},12,"Resumes",80,"resumes",{"id":20,"doc_module":9,"doc_module_name":10,"category_name":21,"show_sort_weight":22,"slug":23},14,"Invoices",70,"invoices",{"id":25,"doc_module":9,"doc_module_name":10,"category_name":26,"show_sort_weight":27,"slug":28},15,"Posters",60,"posters",{"id":30,"doc_module":9,"doc_module_name":10,"category_name":31,"show_sort_weight":32,"slug":33},16,"Social Media",50,"social-media",{"id":35,"doc_module":9,"doc_module_name":10,"category_name":36,"show_sort_weight":37,"slug":38},17,"Forms",40,"forms",{"id":40,"doc_module":9,"doc_module_name":10,"category_name":41,"show_sort_weight":42,"slug":43},18,"Letters",30,"letters",{"id":45,"doc_module":9,"doc_module_name":10,"category_name":46,"show_sort_weight":47,"slug":48},21,"Paper Templates",5,"papers-templates",{"id":50,"doc_module":9,"doc_module_name":10,"category_name":51,"show_sort_weight":4,"slug":52},158,"General","general-158",{"code":4,"msg":54,"data":55},"ok",{"site_id":56,"language":57,"slug":58,"title":59,"keywords":60,"description":61,"schema_data":62,"social_meta":119,"head_meta":121,"extra_data":123,"updated_unix":125},105,"en","mental-status-exam-template-client-and-visit-information","Mental Status Exam Template - Client and Visit Information","","Professional mental status examination (MSE) documentation template for mental health providers, centered on capturing client background and visit context. The form records client identifying information, referral source, examination date and time, and the clinical reason for evaluation. It includes structured prompts for appearance and behavior, level of consciousness and orientation, speech and language, mood and affect, thought process, and thought content, with space to document direct observations, client report, and clinician interaction for accurate diagnostic formulation.",{"@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/mental-status-exam-template-client-and-visit-information/166766/",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/mental-status-exam-template-client-and-visit-information/166766.png","ImageObject",442,249,{"name":88,"@type":89},"Caleb Sterling","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/vnd.openxmlformats-officedocument.wordprocessingml.document","2026-09-25","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 sections are included in this mental status exam template?","Question",{"text":108,"@type":109},"It includes Client and Visit Information, Presenting Reason for Evaluation, Appearance and General Behavior, Level of Consciousness and Orientation, Speech and Language, Mood and Affect, Thought Process, and Thought Content.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What should be documented under “Presenting Reason for Evaluation”?",{"text":113,"@type":109},"Document the client’s current cognitive, emotional, behavioral, and perceptual functioning at the time of the encounter, using direct observation, client report, and clinician interaction.",{"name":115,"@type":106,"acceptedAnswer":116},"How should thought content and safety-related concerns be handled in the form?",{"text":117,"@type":109},"Record whether the client denies or endorses suicidal ideation, homicidal ideation, self-harm thoughts, paranoia, obsessions, compulsions, guilt, hopelessness, delusional beliefs, or other clinically significant preoccupations, and describe details if present. Safety-related content should be reviewed directly when indicated.","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},166766,1788200694,{"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":79,"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":125,"read_time":73},962084925290,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Mental Status Exam Template\nFree mental status exam template for Microsoft Word. Professional clinical documentation template for mental health providers.\nClient and Visit Information\nClient Name: ____________________  Date of Birth: ____________________  MRN/Chart #: ____________________  Date of Examination: ____________________  Time of Examination: ____________________  Location/Setting: ____________________  Examiner: ____________________  Referral Source: ____________________. This mental status examination is completed as part of the current clinical encounter and should be interpreted in conjunction with the client’s presenting concerns, diagnostic history, collateral information, and observed behavior throughout the session.\nPresenting Reason for Evaluation: ____________________. The purpose of this assessment is to document the client’s current cognitive, emotional, behavioral, and perceptual functioning at the time of the encounter. Findings below reflect direct observation, client report, and clinician interaction during the examination period.\nAppearance and General Behavior\nThe client’s appearance was ____________________ with respect to grooming, hygiene, dress, and overall self-care. The client appeared stated age / younger than stated age / older than stated age. Notable observations included ____________________. Posture, gait, and psychomotor activity were observed as ____________________. The client was cooperative / guarded / hostile / withdrawn / overly familiar / disengaged / otherwise ____________________ throughout the evaluation.\nEye contact was ____________________. Rapport was ____________________. No abnormal movements were observed / abnormal movements were noted, including ____________________. The client’s level of engagement was consistent with the demands of the interview and was adequate / limited / variable. Any clinically significant behavioral observations, including agitation, retardation, restlessness, or impulsivity, are documented here to support the overall mental status impression.\nLevel of Consciousness and Orientation\nThe client was alert, attentive, and responsive to the interview. Level of consciousness was appropriately maintained / fluctuating / impaired as evidenced by ____________________. The client demonstrated orientation to person, place, time, and situation / was partially oriented / was disoriented to ____________________. Orientation findings are important for determining the presence of acute confusion, intoxication, delirium, or other neurocognitive concerns.\nIf applicable, the client was able to correctly identify the current date, location, and reason for the visit. Any evidence of confusion, delayed responses, or difficulty tracking the conversation was ____________________. These observations should be considered in context with sleep, substance use, medication effects, medical illness, and psychiatric symptom burden.\nSpeech and Language\nSpeech was normal in rate, rhythm, volume, articulation, and spontaneity / was notable for ____________________. The client’s speech was coherent and goal-directed / pressured / slowed / mumbled / impoverished / loud / soft / monotone / otherwise ____________________. Quantity of speech was appropriate / reduced / excessive / variable. Language use was age-appropriate and understandable / notable for ____________________.\nAny abnormalities in speech may reflect anxiety, mania, depression, psychosis, intoxication, neurologic impairment, or medication effects. The client was able to comprehend questions and respond in a manner that was _________________. No expressive or receptive language deficits were observed / deficits were observed as follows: ____________________.\nMood and Affect\nThe client described current mood as ____________________. Affect was observed to be ____________________ and was congruent / partially congruent / incongruent with stated mood and thought content. Range of affect was full / restricted / constricted ","cbCaikXLr0auovs4","https://ap.wps.com/l/cbCaikXLr0auovs4","docx",11458,"English","# Client and Visit Information\n## Presenting Reason for Evaluation\n# Appearance and General Behavior\n## Eye Contact and Rapport\n# Level of Consciousness and Orientation\n# Speech and Language\n# Mood and Affect\n# Thought Process\n# Thought Content","[{\"question\":\"What sections are included in this mental status exam template?\",\"answer\":\"It includes Client and Visit Information, Presenting Reason for Evaluation, Appearance and General Behavior, Level of Consciousness and Orientation, Speech and Language, Mood and Affect, Thought Process, and Thought Content.\"},{\"question\":\"What should be documented under “Presenting Reason for Evaluation”?\",\"answer\":\"Document the client’s current cognitive, emotional, behavioral, and perceptual functioning at the time of the encounter, using direct observation, client report, and clinician interaction.\"},{\"question\":\"How should thought content and safety-related concerns be handled in the form?\",\"answer\":\"Record whether the client denies or endorses suicidal ideation, homicidal ideation, self-harm thoughts, paranoia, obsessions, compulsions, guilt, hopelessness, delusional beliefs, or other clinically significant preoccupations, and describe details if present. Safety-related content should be reviewed directly when indicated.\"}]","Mental Status Exam Template - Client and Visit Information | DOCX"]