Today’s Date:
Wellbutrin SR / Wellbutrin XL (bupropion) Xanax / Xanax XR (alprazolam) Zoloft (sertraline) Zyprexa / Zyprexa Zydis / Zyprexa IM (olanzapine) Other: Past Psychiatric History. If your child has had prior counseling, psychiatric care, psychiatric hospitalizations, or testing please list: ................
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