Menstrual Cycle-Related Symptom Evaluation
This type of evaluation appointment is for people experiencing mood or anxiety symptoms related to their menstrual cycle. These can include symptoms of depression, anxiety, agitation that occur in the two weeks prior to the start of your period. The symptoms may be a worsening of symptoms you experience throughout the month or may only occur in the two weeks prior to your menstrual cycle.
To help us provide you with a comprehensive evaluation, please provide the following at least two weeks prior to your evaluation date.
Required Records:
- Typed summary of your care, including primary psychiatric diagnoses and medication trials to date (preferably with dates, efficacy, side effects, and reasons medication discontinued) from current (and/or past) psychiatric providers.
We do NOT accept handwritten progress notes. Other pertinent medical records (see below) may be included. - Psychiatrists, psychiatric providers, and psychotherapists will need at least your verbal permission and, in most cases, your written permission in order to release a summary to us. Click here for a Release Form so that we can send our consult recommendations to your providers.
- Menstrual Cycle-Related Evaluation history packet (word document file)
- Daily Record of Severity of Problems (DRSP) (pdf) - Please complete and submit two month daily records of symptoms and problems.
Preferred (if available, but not required at first appoinment)
- Typed summary of care from your treating psychotherapist.
How to Send Required Records to Johns Hopkins Reproductive Mental Health Center
- Please email [email protected] or upload to this secure link
- Alternatively, you may fax materials to 410-502-3755, Attention: Johns Hopkins Reproductive Mental Health Center, using the cover sheet: Download Fax Cover Sheet
Insurance
You are responsible for contacting your insurance company in order to obtain any necessary authorization for this appointment. The Johns Hopkins Department of Psychiatry and Behavioral Sciences contracts with many but not all insurance companies. Therefore, you should personally verify your mental health benefits, in particular, a one-time outpatient psychiatry visit. For patients who have insurance from companies with whom we do not have a contract, we require payment in full at the time of visit.