cate the amount they were bothered by each of the distress symptoms during the preceding week. Patients rated 90 distress symptoms on a five-point Liken scale with being "not at all" and 5 being "extremely." The state- ments are assigned to eight dimensions, reflecting various types of psychopatholo

Onse: Authorized Signer Name: Gender:Mtn: Corpoiate 'Se PhyScal (Homo) Address: Personal Medina Address: Setlai corny Number One Place VS*: Liken Of. Home TNphone Harter Business ne Number. Business Fax Nynex, IS Weber: Address: Yea h Ocoesen: I Phut. Tyne & theater to Itlettheation

ly obligation on debts, (Onvgben eve, be entered O against you? 10 Nave you everfailed in Inv- YES runs. made a compromise mile creditors, or Liken advantage Ilia' hanbruptcy act, 'Yer mown on P1.3) 4 Has your :Davy EMI been garnishee YES an O (a "Yes.' explain on Pg 3) III Have you ever

at South University in West Palm Beach, which is a regionally accredited university, evaluated Ms. educational and work experience background. Dr. Liken concluded, "based on the three-for-one rule set up by the Immigration and Naturalization Service (INS), now known as United States Citizenship and

ed States, Oder to fins r more per* brim. estsirlish Atria, inlay dmiestie TiwlyxUfl pvciek ler the MUNN defemr, print, dormer/Q ad raw the of Liken er reaselres red rrrr fir sediii ad &Wild. tba Crot eP'eekr the I .tifeelOarsrl4rieritli SIGNATURE OF BEARER / SIGNATURE DU TITULAIRE / FIRMA DEL

ed States, Oder to fins r more per* brim. estsirlish Atria, inlay dmiestie TiwlyxUfl pvciek ler the MUNN defemr, print, dormer/Q ad raw the of Liken er reaselres red rrrr fir sediii ad &Wild. tba Crot eP'eekr the I .tifeelOarsrl4rieritli SIGNATURE OF BEARER / SIGNATURE DU TITULAIRE / FIRMA DEL