Collaborate and record You can use this form to return Sooma Therapy records. Please insert your ID: Baseline information: Year of Birth Diagnosis Code(s) Gender ---FemaleMaleOther Handedness ---RightLeftBoth Duration of current episode ---<1 month1-6 months6-12 monthsmore than 1 year Number of past episodes (1) ---01234 or more Treatment resistance (2) ---YesNoUnknown Baseline score Scoring scale Treatment protocol: Treatment type ---Acute treatmenttDCS maintenancerTMS maintenanceECT maintenanceOther Head cap size ---SmallMediumLargeOther Treatments per day ---1Other Treatments per week ---123457Other Treatment weeks ---234681012Other Simultaneous treatments, dosing and changes during the therapy. Post therapy information: Post score Number of completed treatments Please describe effects and/or side-effects of the treatment Treatment was completed successfully ---YesNo If no, why? Consent from the patient to share information Excluding current episode Treatment resistance: inadequate response to at least two antidepressant trial of adequate doses and duration