yes, but I let her finish filling it out for me because I was freaking out and she didn't stay inside the boxes, and didn't put what I saw dr's for she listed the doctors and wrote outside of those boxes, the rest were yes and no boxes and now I will probably get the long form in the mail......I was approved after being denied the first time and I got lawyers and then I was approved and I didn't have to see a judge because he wrote that he reviewed and at my age and the lack of jobs, there would be no way I could get a job at my level , but I was listed as could possible get better, then I got the short form and I didn't know what that meant...I thought that was the start of the whole mess all over again........is there anybody that messed up on the short form and they called u for information or sent u another short form, I mean part of my diagnosis was a cognitive disorder from an aneurysm I had coiled and things just don't make sense to ma a lot of the time