a. Have you heard things that other people couldn’t hear, like noises or voices of people talking when there was no one around?	0□ NO	1□ Yes	□ Refused
b. Have you seen things that other people couldn’t see?	0□ NO	1□ Yes	□ Refused
c. Have you experienced mental health symptoms prompting a visit to the ED or hospital?	0□ NO	1□ Yes	□ Refused
d. Have you had mental health medication changes due to worsening symptoms?	0□ NO	1□ Yes	□ Refused
e. Have you been diagnosed with a severe personality disorder?	0□ NO	1□ Yes	□ Refused
f. Have you made plans about taking your life?	0□ NO	1□ Yes	□ Refused