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Ace Questionnaire PDF Form

Ace Questionnaire PDF Form

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Instructions and help about aces survey

[Music] the adverse childhood questionnaire or eighth questionnaire is a screening tool based on a study completed with 17,000 people from 1995 to 1997 this study sought to determine the effects early childhood trauma have on future behavior and medical issues the three categories include abuse neglect and family and household challenges to administer the questionnaire please keep in mind that this could be highly sensitive information and may be difficult for the patient to discuss offer to read each item individually to the patient depending on their age or allow them to complete the questionnaire by themselves each yes to the ten questions should be totaled a score of one or more indicates increased risk for or more indicates severe risk therefore primary care physicians should recommend further consultation with a mental health provider here is an example of how to administer the tool to patients now I have some questions to ask you that may be a little bit difficult to discuss yo

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