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.

Easily personalize this form template with a HIPAA compliant form builder.

Build a HIPAA compliant form for free

Start saving time and money with FormDr

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.

Discover More Form Features

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

White Labeled Accounts

Have your account match your company branding with FormDr White Labeled Enterprise. Create a customized, branded look without having to build your own HIPAA compliant online form software.

HIPAA Compliant Tablet Forms

Forms on iPads or Tablets

Give patients the option to sign and complete forms online with an iPad or tablet. Online forms work on all tablets and iPads.

Text Message Form Invites

Text Message Invitations

Send a text message invitation to your patients to complete your forms. Give patients the freedom to sign and complete forms with any device, anywhere.

Form Analytics

Form Analytics

Analyze data, improve patient responses, learn from patient behavior and raise your conversion rate. FormDr is the only tool you require to understand the needs of your patients.

They love FormDr - and so do their patients

  • Not having an online custom form to offer patients was a huge struggle. FormDr makes paperwork seamless and saves a ton of time and money by allowing us to upload to patients EMR rather than print, fill out, scan, and then attach. That is now a hindrance of the PAST!

    Woodlands Dermatology
    Angela H.
  • Patients can fill out the forms at their leisure, and don’t have to print anything. We’re collecting more completed forms than ever, and patients love not having to do anything when they come to the office for the first time.

    FYZICAL MetroWest
    Lauren A.
  • FormDr allows me to send and receive attractive, professional forms from patients. Very helpful that I can remind patients of their appointment time and check the status of the form.

    Banks Hepatology Institute PC
    Alpha B.
  • Sending a PDF was too time consuming for the patients to do, and it required the additional steps of printing and scanning it into our own systems. FormDr made it easier to get patients to complete the forms by email, and it’s a more secure way to provide info than simply emailing back a completed PDF.

    Reload Therapy
    Angie I.
  • Before FormDr, the most common struggle were our patients taking a long time to complete forms in our office. Now patients are able to be seen faster when forms are completed prior to visit. Very easy service to create forms online!

    Skin Science Dermatology
    Courtney M.
  • The support is second to none. FormDr has been instrumental in streamlining our intake of new patients.

    Lang Orthodontics
    Eric L.
  • Before, clients weren’t signing our forms before the appointment. FormDr has allowed us to share our documents for client review and signatures. I really appreciate the support, it has been super helpful simplifying our forms!

    Meridian Behavioral Health
    Laura W.

Book a Free Consultation

Schedule a consultation with us to learn more

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

  • Are having patients fill out paper forms during the appointment
  • Are emailing patients a PDF or Word Doc to print out, fill out, scan, and send back
  • Are spending time manually printing and scanning paper forms