Please answer the following questions as they relate to your client who
has been referred for the Safe and Sound Protocol (SSP)

How well does this client self-regulates when distressed?
0=Extremely poorly to 6=Extremely well
arrow&v
How well does this client tolerate positive affect?
0=Extremely poorly to 6=Extremely well
arrow&v
Are you concerned about or aware of any of the following being an issue for this client?
Select applicable
Provide examples of what this client does to self-regulate when distressed?

©2021 by Lesley Hartman & Associates Inc. Proudly created with Wix.com