Behavioral Health Information for All Patients

Waiver for Non-Covered Services

Patient Authorization for Use and Disclosure

Adults

ACEs calculator
Adult ADHD Self-Report Scale (ASRS v1.1)
Adult NP Packet for BHCs
All Screenings Scoring Cheat Sheet Version 1
Anxiety – GAD-7
Bipolar – Mood Charting
Cage Questionnaire
Cigarettes Dependence Scale 5
Depression – Hamilton Depression Scale
Depression – PHQ – 9 – Adult
Duke Health Profile
Eating – EAT – 26
Edinburgh Scale
Hamilton Anxiety Scale
MDQ
Mini Mental State Exam MMSE
OCD – YBOC Rating Scale
OCD – YBOC Symptom Checklist
Opioid Risk Tool
PTSD PC-PTSD
Quality of Life Scale
Self-Efficacy for Managing Chronic Disease
Session Rating – Patient’s-Visit Rating Scale (SRS)
SPIN
Stress – Hidden Stress Questionnaire
Substance use – ASSIST V-3
Substance use – Cage Questionnaire
Suicidality – SBQ-R
Wender Utah Rating Scale

Pediatrics

ACE – Q – CHILD – Parent – Caregiver
ACE – Q – TEEN
ACE – Q – TEEN – Parent – Caregiver
ADHD – Vanderbilt Initial Teacher assessment
ADHD – Vanderbilt Initial Parent assessment
ADHD – Vanderbilt Parent Follow Up
ADHD – Vanderbilt Teacher Follow Up
Adolescent NP Packet for BHCs
Anxiety – GAD – A – Ages 11 – 17
Anxiety – SCARED – Parent
Anxiety – SCARED – Child and Adolescent
CFAFFT
Depression – Columbia Depression Scale Teen Parent
Depression – PHQ – 9 – Modified Teens
Eating – EAT – 26
Pediatric symptom checklist – Youth Report
Pediatric Symptom Checklist
Pictorial Pediatric Symptom Checklist
Session Rating – Child Session Rating Scale (CSRS)
Substance use – CRAFT + N – Adolescent