Grief Evaluation Form Template

Easily send confidential patient grief evaluation forms online. Patients can complete forms prior to the appointment on their phone, tablet, or computer, at their own pace in a private manner. Patients securely complete needed assessments and submit them directly to your account. Track your patient’s progress, send automated appointment reminders, and receive completed evaluation forms online.
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Grief Evaluation for Children and Teenagers (17 and under) Template

Give your patients the freedom to complete grief evaluation forms from any device, anywhere. Streamline the way you collect patient information and record their responses by setting up your form online.

Easily personalize this Grief Evaluation Form Template with a HIPAA compliant form builder.

What is the Grief Evaluation Form?

A grief evaluation form is an assessment used to help providers understand the grief symptoms the patient is experiencing, including how grief is impacting the individual, family, and everyday activities. The form can guide conversations between the provider and patient, and help measure progress or changes in grief over time. 

The death of a family member, friend or other significant person is a lifelong loss for children. It is normal for children to miss the person who died and to experience grief that might come and go with different levels of intensity for some time after the death. It can be challenging to parents and caregivers to know what to do for, what to say to and how to help children who are obviously hurting.

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Patient Health Questionnaire (PHQ-9)

Give your patients the freedom to complete the PHQ-9 from any device, anywhere. Ensure privacy and help keep teens safe by ensuring completion of this screening form before their clinic visit.
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Grief Evaluation for Children & Teenagers (17 and Under)

Collect valuable information concerning your patient’s grief experience and daily life. Review this information prior to the appointment to guide the conversation.
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Cancellation Policy

Collect signed acknowledgements of the clinic cancellation policy online before the appointment. Informed patients provide better communication, which in turn reduces your clinic no-shows and late cancellations.
Medical Intake Form Template

Medical Intake Form

Easily have patients complete your medical intake forms online. Completed medical intake forms are submitted securely to your account, before the patient's appointment.
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Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist

Give patients the freedom to complete the adult ADHD self-report checklist at the most comfortable an convenient time, with a phone, tablet, or computer. Information is submitted securely and is ready for your review before the appointment.

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Use this standardized screening checklist to identify postpartum depression symptoms and determine the severity of illness.
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Medical Release Form

Turn your paper medical history forms into HIPAA compliant online forms. Streamline your forms by removing the paperwork. Collect a more accurate medical history from your patients.
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No Surprises Act Template

Send your patients your practices No Surprises Act notice, quickly and easily online.

Streamline patient forms and engagement

Collect forms. Engage patients. Automate follow-up.

Discover More Form Features

Setup HIPAA compliant online forms. Streamline your process of collecting information from patients.
Resend HIPAA Compliant Forms

Resend HIPAA Compliant Forms

Resend completed patient intake forms. Patients will simply update what has changed, and leave the rest of the form completed.

Conditional Logic

Conditional Logic Forms

Only show information that is relevant to the patient with conditional logic forms. Make it simple for your patients to complete your forms and improve the accuracy of the data you receive with conditional logic.

Print HIPAA Compliant Submissions

Print HIPAA Compliant Form Submissions

Print your patients’ submissions after the forms have been completed online. Adjust the formatting and text size to match your original paper forms.

Custom Logo and Branding

Custom Logo, Brand, and Styling

Add your logo to your forms and set the colors to match your brand. Pick the background of your forms, customize the gradient of your buttons, and select the field text color.

Book a Free Demo

Schedule a demo to see how FormDoctor can streamline patient forms and automate engagement.

FormDoctor gives your practice one HIPAA-compliant platform to collect forms, communicate with patients, and automate follow-up. We help practices who:

  • Are still using paper forms, PDFs, or Word documents
  • Spend too much time printing, scanning, emailing, and calling patients
  • Need an easier way to send reminders and automate follow-ups
  • Want to streamline forms, communication, and paper workflows