See You Next Week Assessments

SYNW Weekly Assessment Confidentiality Notice

The See You Next Week (SYNW) Weekly assessment are used to support your therapy sessions by helping your therapist understand your current symptoms and areas of focus.To protect your privacy, please use your assigned Client ID only when completing this form. Do not include your name or other identifying information.This form is not intended for emergency communication or crisis support. If you are experiencing thoughts of harm to yourself or others, please contact your therapist directly, call 988, or go to your nearest emergency room.Information submitted through this form will be reviewed by your assigned therapist and used as part of your clinical care.
Client ID (Assigned to you in your welcome email)
Therapist Name*
Date*

YearMonthDay
Date

Over the last two weeks, how often have you experienced the following symptoms?*

Rows	Not at all	Several Days	More than half the days	Nearly every day
1. Little interest or pleasure in doing things
2. Feeling down, depressed or hopeless
3. Trouble falling or staying asleep, sleeping too much
4. Feeling tired or having little energy
5. Poor appetite or overeating
6. Feeling bad about yourself-or that you are a failure or have let yourself or your family down
7. Trouble concentrating on things, such as reading the newspaper or watching television
8. Moving or speaking so slowly that other people could have noticed. Or the opposite-being so figety or restless that you have been moving around a lot more than usual
9. Thoughts that you would be better off dead, or of hurting yourself

Over the last 2 weeks, how often have you been bothered by the following problems?*

Rows	Not at all	Several Days	More than half the days	Nearly every day
1. Feeling nervous, anxious, or on edge
2. Not being able to stop or control worrying
3. Worrying too much about different things
4. Trouble relaxing
5. Being so restless that it is hard to sit still
6. Becoming easily annoyed or irritable
7. Feeling afraid as if something awful might happen

SYNW Weekly Assessment Confidentiality Notice