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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HIPAA Compliant Submission Audit Logs

Submission Audit Logs

Form submissions have a detailed history that can always be referenced. Audit logs cannot be changed and the history from all users is tracked.

HIPAA Compliant Form Kiosk

Kiosk Form Page

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Form Analytics

Form Analytics

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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.

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

  • Are having patients fill out paper forms during the appointment
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  • Are spending time manually printing and scanning paper forms