Notum

Declaration of a person applying for a permit to acquire a firearm (Asmens, norinčio gauti leidimą įsigyti ginklą, garbės deklaracija)

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Your details

1. Is there, or has there been, anyone with a mental illness in your family or among your first-degree relatives (parents, guardians, brothers, sisters)?
2. Has anyone in your family or among your first-degree relatives (parents, guardians, brothers, sisters) died by suicide?
3. Is there, or has there been, anyone in your family dependent on alcohol (with health, social, legal or other alcohol-related problems)?
4. Have you had a brain injury with loss of consciousness?
5. Have you had epileptic or other seizures with loss of consciousness?
6. Have you acquired a weapon for self-defence?
7. Are you currently taking medicines for any illness?
8. Do you have any complaints about your mental health?
9. In the last 10 (ten) years, have you had mental disorders or a mental illness for which you were treated with medicines, received psychotherapy, etc.?
10. Are you currently taking sedatives or other psychoactive medicines prescribed by a doctor?
11. Have you ever taken sedatives, painkillers or other psychoactive medicines that were not prescribed by a doctor?
12. Is your capacity for work limited because of an illness or other health problems?
13. Do you have sleep disorders?
14. Do you feel anxious when you wake up in the morning? Do you feel anxious for no reason during the day?
15. Do you have mood swings?
16. Do you feel that your future is hopeless and nothing can get better?
17. In your opinion, do you need to consult a psychologist, a psychiatrist or a psychotherapist?
Declaration of a person applying for a permit to acquire a firearm (Asmens, norinčio gauti leidimą įsigyti ginklą, garbės deklaracija) — Notum