Intake Evaluation/Practice Forms

​

• Introduction Letter​

• Contact Information Form

• Practice Policies

• History Questionnaire, Adult

• History Questionnaire, Youth

• Release of Information

• Informed Consent for Telehealth (Video) Sessions

• Credit Card Authorization Form

​

Symptom Scales 

​

• General

  • Mood Chart

  • Mood Chart, IBF

  • Mood Chart, Alternative
  • Mood Diary, Simple
  • Mood Tracking Apps
  • Mood/Energy Thermometer
  • Mood/Energy Thermometer, Simplified
  • Mood/Energy Thermometer, Monitoring Card

• Cognitive Functioning

  • Cognitive Complaints In Bipolar Disorder Rating Assessment​

• Attention, Impulsivity, and Behavior​​

  • Daily Report Card​​

  • Weekly Monitoring Report​​​​​​​

  • ADHD, SNAP Scale, Long Form

  • ADHD, SNAP Scale

  • ADHD, SWAN Scale, Youth

  • ADHD, Connor's Scale

  • ADHD, Vanderbilt Scale, Parent

  • ADHD, Vanderbilt Scale, Teacher

  • ADHD Adult Scale

• Depression

  • Depression Screen, PHQ-9​

  • Depression Screen, PHQ-9, Teens

  • Depression Screen, PHQ-9, 11-17 yo

• Anxiety

  • SCARED, Adult Version

  • SCARED, Parent and Child Version

  • SCARED, Child Version

  • Generalized Anxiety Screen​

  • OCD Screen

  • OCD Screen, Youth

  • OCD Screen, Youth, Severity

  • Social Anxiety Screen

  • Panic Disorder Screen

  • PTSD Checklist-Specific

  • Anxiety Tracker from Understood.Org

  • Anxiety Pattern Finder from Understood.Org

• Bipolar Spectrum

  • Mood Disorder Questionnaire​

  • Mood Disorder Questionnaire​, Teens, Parent Version

  • Bipolar Disorder Screen​, Youth, Parent Version

  • Bipolar Disorder Questionnaire, Youth, Girl

  • Bipolar Disorder Questionnaire, Youth, Boy

  • Bipolar Depression Scale

  • Mania Scale

  • Mania Scale, Youth, Parent Version

• Autism

  • Paper on Autism Spectrum Scale, Youth​ (not yet available as a publicly available scale)

• Other

  • Dissociative Experiences Scale​

​

​

​

​