Follow the steps to effectively complete the form.

1. Click the ‘Get Form’ button to access the NSLIJHS Trauma History Checklist and Interview. This will allow you to open the form in an editable format.
2. Begin by filling out the date of the interview at the top of the form. Record today's date to ensure accurate documentation.
3. Next, provide the name of the interviewer in the specified field. Ensure that the spelling is correct for proper identification.
4. Enter the evaluation number in the designated space. This number will help track the assessment associated with this form.
5. In the checklist section, answer each trauma-related question by placing a 'Y' for yes or 'N' for no before each item. Ensure that your responses reflect your experiences honestly.
6. For questions you answer 'Y,' provide additional details in the specified area. Include the age of onset and duration of the trauma as relevant.
7. Once you have filled out all the necessary information in the checklist, identify and document the most significant traumatic event at the bottom of the sheet. This information should include the date, age at occurrence, and a brief description.
8. After completing the form, review all provided information to ensure clarity and accuracy. Ensure all fields are properly filled before finalizing.
9. Save your changes, and consider downloading or printing a copy for your records. You also have the option to share the completed form if required.

Complete your NSLIJHS Trauma History Checklist and Interview online today.