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Instructions for the Clinical Self-Report Form
by Gary Sachs, M.D.


General Instructions:
The Clinical Self Report Form was designed to systematically collect information about the symptoms commonly experienced by patients with mood disorders. Collecting information at each visit allows your doctor to better track the course of your symptoms and your response to treatment. Answering standard questions before your visit allows for more productive time with your doctor. We strongly recommend filling one out at each visit.


What is...?
The Massachusetts General Hospital
Bipolar Clinic and Research Program
50 Staniford Street, 5th Floor; Boston, MA 02114
P: (617) 726-6188 | F: (617) 726-6768

Treatment by clinic staff or MGH-affiliated clinics and studies can
NOT be arranged through this site or contact e-mail.


This web site, its contents, and contact information are designed for informational purposes only,
and must not be substituted for professional care.
Consult a physician or primary care doctor if you
believe that you are experiencing symptoms of any illness.
If you are experiencing an medical emergency, call 911 immediately.
© 2004 The MGH Bipolar Clinic and Research Program