To monitor our patients’ progress, we advise patients to please fill out these forms at least once or twice a week.
BAI is an assessment tool used to measure anxiety and can be self-administered or administered by a clinician.
Named of which is an acronym of its four questions, CAGE is a widely used method of screening for alcoholism.
Designed to identify behaviours and abilities indicative of Asperger’s Syndrome in children during primary school years.
Primary Care PTSD Screen (PC-PTSD)
The PC-PTSD is a 4-item screen that was designed for use in primary care and other medical settings and is currently used to screen for PTSD in veterans at the VA.
The PHQ-9 is the nine item depression scale of the Patient Health Questionnaire. The PHQ-9 assists primary care clinicians in diagnosing depression and selecting treatment.
Arizona Sexual Experiences Scale (ASEX)
Pain Management Patient Questionnaire
MDQ (Mood Disorder Questionnaire)
ASRS (ADHD Screen)
MADRS (Montgomery Asberg Depression Rating Scale)
Please note: These forms are in Portable Document Format (pdf) and require a pdf reader. If your computer does not have a pdf reader, you may download Adobe Reader X for free here.
Reader X download note: The download is preset to automatically include, for free, both the Google Chrome Internet Browser and the Google Toolbar for Internet Explorer.
These are optional and are NOT required to view and/or print Integrated Clinical Neurosciences/Silicon Valley TMS forms. If you do NOT want them included in your download, be sure to CLEAR the check box called “Yes, install Chrome as my default browser and Google Toolbar for Internet Explorer – optional.(32.11 MB)”.