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PSI Questionnaire

Steps

  1. 1. Step One
  2. 2. Step Two
  3. 3. Step Three
  4. 4. Step Four
  5. 5. Step Five
  6. 6. Step Six
  7. 7. Step Seven
  8. 8. Step Eight
  9. 9. Step Nine
  10. 10. Step Ten
  • Step One

    1. Are you a United States citizen?

    2. Mailing address (if different)

    3. Did you serve any jail time as a result of the arrest within this Court Case?

    4. Did you post any Bail in this Case?

    5. PRIOR RECORD

    6. Have you ever been incarcerated for any crime?

    7. If incarcerated, have you ever been disciplined within the facility (verbal warning, sent to segregation, etc.)?

    8. Have you ever been on probation?

    9. Are you currently on probation?

    10. Do you have any other pending offenses?

    11. Have you ever violated probation or conditions of release?

    12. EMPLOYMENT/FINANCES

    13. What is the current status of your employment? (check which applies)

    14. Do you like your present employment?

    15. Do you spend time outside of work with your co-workers?

    16. List your three most recent places of employment, giving the present/most recent first.

    17. Have you ever been fired from employment?

    18. List any other sources of income (include Social Security, child support, disability, unemployment, income from spouse or significant other, etc.):

    19. List major monthly expenses paid per month (house payments, rent, credit card payments, car payments, cell phone bills, utilities, medical bills, etc.):

    20. Do you have any debts?

    21. If yes, please list below:

    22. Are you worried about having enough money to meet your needs?

    23. In the past year, have you experienced any financial problems?