Informant Name Informant Type Rating Scale Date

Bill Withers Informant SNAP IV 10/18/2012 Bill Withers Informant SNAP IV 11/27/2012 Bill Withers Informant SNAP IV 01/01/2013 Bill Withers Informant SNAP IV 02/15/2013 Bill Withers Informant SNAP IV 02/28/2013