PHQ-9 Teens Form Template

The PHQ-9 form is a Patient Health Questionnaire (PHQ) with 9 questions designed to screen for depression and suicidal ideation. The modified teen form is designed for patients ages 12 though 18. Teens can now submit this form electronically from their phone, tablet, or computer – allowing them the time and privacy to complete these very personal questions prior to an appointment.
PHQ-9-Modified-for-Teens

PHQ-9 Form Modified for Teens

Give your teen patients the freedom to complete the PHQ-9 Modified for Teens form with any device, anywhere. Ensure that teens are comfortable and respond privately by setting up your form online.

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What is a PHQ-9 Modified for Teens Form?

This form includes 9 targeted questions to assess symptoms of depression and suicidal intent. By consistently screening patients, at-risk teens can be identified and helped with an appropriate treatment plan.  

Early detection is a critical prevention strategy. The majority of people who die by suicide visit a healthcare provider within months before their death. This represents a tremendous opportunity to identify those at risk and connect them with mental health resources.

The liability falls on you to handle patient data in a compliant way. Patient privacy is a serious topic, legislation from the Health Insurance Portability and Accountability Act to the Patient Protection and Affordable Care Act place heavy fines on medical professionals who mistreat patient information.

A medical release form does not empower your staff to share patient information with just anyone. Depending on what is included in the form, the document may release medical information to the patient’s family, other doctors, insurance providers, attorneys, or anyone who may make healthcare decisions on behalf of the patient.

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Embed Forms on Website

Embed your forms directly on your website for a seamless experience for your patients. Your forms are customized with your logo, brand, and styling to match your site. Embed on Wordpress, Wix, Squarespace, and many more.

HIPAA Compliant Electronic Signatures

HIPAA Compliant Electronic Signatures

Collect electronic patient signatures before the appointment. Easily give your patients the ability to digitally sign from their phone, tablet, or computer.

Encrypted HIPAA Compliant Forms

Encrypted HIPAA Compliant Forms

Your forms are protected with a 128-bit secure socket layer which encrypts your patient’s data. Securely collect patient forms online with HIPAA compliant online forms.

Account Audit Logs

Account Audit Logs

Keep a detailed record of your account and export your history as a CSV Excel file or Google Sheet. Quickly export every event from your account; or, select a date range or user’s history to export.

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FormDr gives your practice everything needed to easily send and receive HIPAA compliant forms online. We help practices who:

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