Format of Psychological Evaluation Report (Final)
Format of Psychological Evaluation Report (Final)
I. Identifying Information
- Describe the client's demographic characteristics here. 2-3 sentences
II. Reason for Referral
- Explain the circumstances of referral (referring person / agency / self-referred). What is
the purpose of the present evaluation. 2-3 sentences
III. Presenting Problems
- Explain the presenting problems encountered relevant to reason for referral.
IV. Background Information
- Include Family background and Personal History (may be chronological)
V. Behavior Observation
- what relevant behaviors were observed during intake interview and testing
VI. Sources of Information
Intake Interview and Behavior Observation of the Client
Test Instruments Administered:
ABAS
BPI/ NEO Five Factor Inventory (NEO-FFI)
PNLT
Problem Experience Checklist by WPS
RIASEC
TSCC
Draw a Person/House Tree Person Test
Sack's Sentence Completion Test
Thematic Apperception Test
VII. Test Results and Interpretation
A. Intellectual Functioning
a. Career Interest Results (RIASEC)
b. Mental Ability Test Results (PNLT)
B. Adaptive Functioning (ABAS)
C. Personality Profile - include table and integrated explanation, use the findings from
objective personality test results here (integrate BPI/ NEO-FFI results)
D. Socio-emotional Functioning - integrate all the findings from the projective test
results (DAP/HTP/SSCT/ TAT/Problem Experience Checklist (WPS) here, no need for
table or no need to append drawing and stories
VIII. Summary
- Summarize the assessment results here vis a vis the reason for referral / presenting
problems. You may opt to have a diagnostic impression (only if applicable)
IX. Recommendations
- Can be in bullet sentences
Prepared by:
Your e-signature
Your Name and License Number (if applicable)