Complete a form or questionnaire prior to your visit and hand to front desk staff for entry into your electronic records. Alternatively, you may be requested by staff, or doctor/nurse to do this prior to, during, or after your visit.
Pain
- BPI -brief pain inventory. Complete for pain that have affected your life for at least a week.
- Back pain disability score
- Pain disability index
- Hip and knee pain disability
Sleep Disorder
Do you have obstructive sleep apnea?
Seniors
Staying independent, Fall Risk Questionnaire
Menopause
Mental Health
- Generalized anxiety disorder 7 item (GAD 7)
- Depression. Patient health questionnaire (PHQ-9)
- PTSD screening tool
- Adverse childhood experiences questionnaire (ACE)
- Postpartum depression questionnaire
- Substance use risk teens
- Children’s mental health symptom checklist
- Bears sleep screening algorithm ages 2-18
- Alcohol-CAGE-AID questionnaire
- Prediction of alcohol withdrawal severity scale (PAWSS)
- Adult ADHD self-report scale
- Childhood ADHD: Weiss functional impairment rating scale – PARENT
- Childhood ADHD: Weiss functional impairment rating scale – TEACHER
- ADHD medication management follow-up
- Childhood autism Spectrum test
- Autism Spectrum quotient (self-administered questionnaire screening for autism spectrum traits in adults)