["I'm applying for MYSELF to participate in a program","","","","","","","","","","NDIS","","","","430473305","HIKES\u00a9","","","","","","","","","","","","HIKES\u00a9","Beginner Hiker","Have just completed hiking Kings Canyon in the NT","I has spinal lumber surgery 5 months ago so I feel  I have lost my confidence and abilities","","Shane","","Stephens","","Stephens.shane@yahoo.com.au","1959-03-29","0434994995","64","18 Seppelt Street","","18 Seppelt Street","Wilsonton Heights","Qld 4350","Australia","Shane met the full DSM 5 diagnosis criteria for:\r\n\uf0b7 309.81 Complex Post Traumatic Stress Disorder, with Dissociative Symptoms of Depersonalization and dissociation, with Psychotic features of both auditory and visual intrusions, with nightmares terrors and nightmares.\r\n\uf0b7 Major Depressive Disorder, Unrelenting and cyclic, with mixed features of Anxiety and Melancholy.\r\n\uf0b7 Panic Disorder, Severe. With additional Physical Disability of:\r\n\uf0b7\r\nChronic Pain Disorder, with extreme loss in daily functioning in body regions inclusive but not limited to shoulders, back, legs, neck wrists and hands as direct impacts upon Shane\u2019s body form enduring years of physical violence and torture as a child and adolescent.","I love the feeling of air on my skin and freedom","Better health","Yes","Medication, treatment or intervention (includes non-pharmacological supports)\r\n Date started\r\n Date ceased\r\n  Effect on the impairments\r\nOlanzapine 2.5mg daily\r\n21\/04\/2020\r\nongoing\r\nEffective\r\nPartially effective\r\nNot Effective\r\nUnsure\r\n Not tolerated\r\nPregabalin 300mg 2 x daily\r\n26\/03\/2019\r\nongoing\r\nEffective\r\nPartially effective\r\nNot Effective\r\nUnsure\r\n Not tolerated\r\nMirtazapine 45mg 1 x daily\r\n24\/06\/2019\r\nongoing\r\nEffective\r\nPartially effective\r\nNot Effective\r\nUnsure\r\n Not tolerated\r\nValpro EC200 200mg 3 x daily\r\n01\/10\/2019\r\nongoing\r\nEffective\r\nPartially effective\r\nNot Effective\r\nUnsure\r\n Not tolerated\r\nPhysiotherapy\r\nDowns Physiotherapy St Andrews Hospital Toowoomba QLD 4350\r\n01\/06\/2019\r\nongoing\r\nEffective\r\nPartially effective\r\nNot Effective\r\nUnsure\r\n Not tolerated\r\nDr Hardus Cronje Psychiatrist\r\n5 Aubigny Street Toowoomba QLD 4350\r\n01\/10\/2019\r\nMonthly ongoing\r\nEffective\r\nPartially effective\r\nNot Effective\r\nUnsure\r\n Not tolerated\r\nMary Gordon\r\nGrey Matters Psychotherapy Toowoomba QLD 4350\r\nongoing\r\nEffective\r\nPartially effective\r\nNot Effective\r\nUnsure\r\n Not tolerated\r\nDr John O\u2019Bryen Downs Rural Medical Whyalla Plaza Toowoomba QLD 4350\r\n01\/01\/2015\r\nongoing\r\nEffective\r\nPartially effective\r\nNot Effective\r\nUnsure\r\n Not tolerated\r\n Dr Daniel Berge Interventus Pain Specialists Wesley Hospital\r\nSuite 20a Level 10 Auchenflower 4066\r\n  02\/02\/2019\r\n ongoing\r\n   Effective\r\n  Partially effective\r\n  Not Effective\r\n  Unsure\r\n  Not tolerated\r\n                     Developed by the Transition Support Project, in conjunction with the NDIA, with funding from the Department of Social Services, September 2019.\r\n9\/9\r\n \r\n  Dr David Walker Briz Brain Spine Wesley Hospital Auchenflower 4066\r\n  02\/01\/2019\r\n 05\/03\/2019","No","","155","99","Very Low","","Allan","","Stephens","","Husband","0407200168","Doctors Report","Specialist Report","Psychology Report","Psychiatrist Report","Occupational Therapy Report","","","","Physiotherapy Report","","","","","","","","","","","Plan Managed (External company eg. Leap-In, Connect)","","","Plan Partners","invoice@planpartners.com.au","","Core Supports | Assistance with Daily Life - Therapy-Related Health Supports","","","","","","","","","","","","","","","","","","","","","","","","","","Friday","","","","","","","Mid Afternoon - approx 3pm-5pm","","","No","","","","","","","","Participant \/ representative has read (or had clearly explained), understands and agrees to the Privacy Policy","Participant \/ representative has read (or had clearly explained), understands and agrees to the Terms and Conditions","I have understood the relevant overview document and acknowledge that I will be invoiced for the initial assessment and will make payment within 7 days.","Participant \/ representative has read (or had clearly explained) and understands this Assumption of Risk and Waiver of Liability","https:\/\/opentrax.com.au\/index.php?gf-signature=6351b4aa05df02.89037779&form-id=30&field-id=104&hash=9a64509dcab93e38604ed5e68fe9ffcb17ca5a672853398462ee689566a7c960","","Shane","","Stephens","","2022-10-21","","573","2022-10-21 06:50:50","2022-10-20 20:50:50","https:\/\/opentrax.com.au\/lp-courses\/initial-program-onboarding-form\/","","","","","","API","58.161.164.156","","","","","","3","","","","","","","","fa07e6221b68f76bd0323f00f46b1a2e","a337e2","","","","","","","","","","","","0","0","0","0","0","0","0","0","0","0","0","","[{\"id\":\"364\"\\,\"user_id\":\"0\"\\,\"date_created\":\"2022-10-20 20:50:51\"\\,\"value\":\"HIKES Tag - Referer: A valid email address must be provided.\"\\,\"note_type\":\"gravityformsmailchimp\"\\,\"sub_type\":\"error\"\\,\"user_name\":\"Mailchimp\"\\,\"user_email\":null}\\,{\"id\":\"365\"\\,\"user_id\":\"0\"\\,\"date_created\":\"2022-10-20 20:50:55\"\\,\"value\":\"WordPress successfully passed the notification email to the sending server.\"\\,\"note_type\":\"notification\"\\,\"sub_type\":\"success\"\\,\"user_name\":\"Chris Notification (ID: 62b1b684d001e)\"\\,\"user_email\":null}\\,{\"id\":\"366\"\\,\"user_id\":\"0\"\\,\"date_created\":\"2022-10-20 20:50:57\"\\,\"value\":\"WordPress successfully passed the notification email to the sending server.\"\\,\"note_type\":\"notification\"\\,\"sub_type\":\"success\"\\,\"user_name\":\"Send Application Information To Asana (ID: 62df6410a0c52)\"\\,\"user_email\":null}]","https:\/\/opentrax.com.au\/pdf\/62df3eed4e57c\/573\/","2022-10-20 20:50:50"]