99+ customizable healthcare form templates for every specialty.
Every validated screener, every common consent, every specialty intake. Preview any template, then use it inside Zentake, auto-scored and EHR-ready.
Generalized Anxiety Disorder-7
Industry-standard 7-item anxiety screener. Auto-scored and validated for DSM-5. The most common companion to the PHQ-9.
Patient Health Questionnaire-9
Validated 9-item depression screener with auto-scored severity bands. The most-used depression instrument in primary and behavioral health.
AD8 Dementia Screening Interview
The AD8 Dementia Screening Interview is an eight-item informant tool that flags cognitive change, scored automatically in Zentake before the visit.
Adult ADHD Self-Report Scale v1.1
Adult ADHD Self-Report Scale (ASRS) v1.1: a WHO 18-item checklist with a 6-item adult ADHD screener. See scoring, cutoffs, and how Zentake automates it.
Adult Adverse Childhood Experiences Questionnaire
The ACE-Adult (Adverse Childhood Experiences questionnaire) is a 10-item childhood-trauma screen. Scoring, interpretation, and best practices.
Adult Attachment Questionnaire
The Adult Attachment Questionnaire (AAQ) measures adult attachment anxiety and avoidance across 17 self-report items. Auto-score it in Zentake.
Adult Biopsychosocial Assessment
The Adult Biopsychosocial Assessment is a mental health intake form capturing biological, psychological, and social history to guide diagnosis and treatment.
Adult Brief Dissociative Experiences Scale
The DES-B (Adult) is an 8-item DSM-5 screener measuring dissociative symptom severity. Send, auto-score, and track it in Zentake.
Adult General Medical History
Free Adult General Medical History form template for primary care: capture past conditions, medications, allergies, and family history before the visit.
Advance Beneficiary Notice of Non-Coverage
The Advance Beneficiary Notice of Non-Coverage (ABN) template tells Medicare patients when a service may not be covered and who pays.
Adverse Childhood Experiences Questionnaire
Adverse Childhood Experiences Questionnaire (ACE): a 10-item yes/no screen scoring childhood adversity from 0 to 10.
Aging Males Symptoms Scale
The Aging Males Symptoms Scale (AMS) is a 17-item self-report questionnaire measuring age-related symptoms in men across three domains.
Alcohol Use Disorders Identification Test (Consumption)
3-item alcohol use screener. Auto-scored, validated for primary care, and used by the USPSTF.
Altman Self-Rating Mania Scale
The Altman Self-Rating Mania Scale (ASRM) is a 5-item self-report screen for manic and hypomanic symptoms, scored 0-20 (cutoff 6).
Androgen Deficiency in the Aging Male
The ADAM (Androgen Deficiency in the Aging Male) is a 10-item yes/no screen for low testosterone symptoms in aging men.
Appearance Anxiety Inventory
A validated 10-item measure of appearance anxiety in body dysmorphic disorder (BDD), auto-scored in Zentake.
Appointment Cancelation Policy
Appointment Cancelation Policy template: set notice windows, no-show fees, and patient sign-off. Free to customize with Zentake.
Auditory Vocal Hallucination Rating Scale
The AVHRS (Auditory Vocal Hallucination Rating Scale) is a 16-item structured interview that rates voice-hearing severity and impact.
Authorization to Release Medical Information
Authorization to Release Medical Information (ROI) template: what a HIPAA-compliant records release form includes and how to run it in Zentake.
Autism Spectrum Quotient-10, Adolescent
AQ-10 Adol screens adolescents ages 12 to 15 for autistic traits with 10 items scored 0 to 10 and a referral cutoff of 6.
Autism Spectrum Quotient-10, Adult
The AQ-10 Adult is a 10-item autism trait screener for adults 16+. Learn scoring, the score-of-6 referral cutoff, and how Zentake automates it.
Autism Spectrum Quotient-10, Child
The AQ-10 Child is a 10-item parent-report screener that flags autism traits in children ages 4 to 11 and guides referral.
Autism Spectrum Quotient, 50-item
The Autism Spectrum Quotient (AQ) is a 50-item self-report screen for autistic traits in adults, scored and tracked in Zentake.
Autism Spectrum Screening Questionnaire
Auto-score the ASSQ, a 27-item parent and teacher rating that screens for autistic traits in children and adolescents aged 6 to 17.
Bath Ankylosing Spondylitis Disease Activity Index
The BASDAI is a six-item scale scoring ankylosing spondylitis disease activity from 0 to 10. Learn scoring, the score-4 cutoff, and administration.
Beck Depression Inventory-II
The Beck Depression Inventory-II (BDI-II) is a 21-item self-report scale measuring depression symptom severity in patients 13 and older.
Berg Balance Scale
The Berg Balance Scale (BBS) is a 14-item, 0 to 56 clinician-scored measure of balance and fall risk in older adults and rehab patients.
Bipolar Depression Rating Scale
The Bipolar Depression Rating Scale (BDRS) is a 20-item clinician-rated measure of depressive and mixed symptoms in bipolar disorder.
Bournemouth Questionnaire
The Bournemouth Questionnaire (BQ) is a seven-item biopsychosocial outcome measure for back and neck pain. Learn scoring, domains, and clinical use.
Brief Dissociative Experiences Scale
The DES-B (Brief Dissociative Experiences Scale) is an 8-item measure of dissociative symptom severity. Auto-score it in Zentake before the visit.
Cannabis Use Problems Identification Test
The Cannabis Use Problems Identification Test (CUPIT) is a 16-item screen for cannabis use disorder and risk of cannabis-related harm.
Center for Epidemiological Studies Depression Scale for Children
The CES-DC is a 20-item screen for depressive symptoms in children and adolescents, scored 0 to 60 with a recognized cutoff of 15.
Childhood Autism Rating Scale, Second Edition
The CARS-2 (Childhood Autism Rating Scale, Second Edition) is a 15-domain clinician rating scale that identifies autism and grades symptom severity.
Chiropractic New Patient Intake
Chiropractic New Patient Intake template: capture history, symptoms, and consent before the first visit. Free, HIPAA-ready with Zentake.
Clinical Institute Withdrawal Assessment for Alcohol
The CIWA-Ar (Clinical Institute Withdrawal Assessment for Alcohol) is a 10-item scale scoring alcohol withdrawal severity to guide monitoring.
Clinical Opiate Withdrawal Scale
The Clinical Opiate Withdrawal Scale (COWS) is an 11-item clinician-rated measure of opioid withdrawal severity. Score and track it with Zentake.
Clinical Outcomes in Routine Evaluation-10
The CORE-10 is a 10-item measure of psychological distress scored 0 to 40, used to screen adults and track change across mental health care.
Clinical Outcomes in Routine Evaluation, Outcome Measure
The CORE-OM is a 34-item measure of global psychological distress. Send, auto-score, and track it in Zentake, ready before the visit.
Columbia Suicide Severity Rating Scale
Clinician-informed suicide risk assessment. Conditional escalation routes high-risk responses to an on-call clinician in real time.
Comprehensive Dental & Medical History
The Comprehensive Dental & Medical History form collects patient health and dental background before a dental visit.
Consent for AI Scribe Use
Consent for AI Scribe Use template: a HIPAA-friendly consent so patients can approve ambient AI documentation before the visit.
Counseling New Patient Intake
Counseling New Patient Intake template: presenting concerns, mental health history, risk screening, and consent, ready before the first session.
DBT Ways of Coping Checklist
The DBT Ways of Coping Checklist (DBT-WCCL) is a 59-item self-report of DBT skills use and dysfunctional coping.
Dental Financial Responsibility Agreement
The Dental Financial Responsibility Agreement is a dental billing form covering insurance, copays, missed-visit fees, and the payment terms patients agree to.
Dental New Patient Registration
Dental New Patient Registration template: standard patient information fields, digital intake, and HIPAA-secure setup from Zentake.
Dental Records Release Authorization
The Dental Records Release Authorization is a HIPAA form that lets patients authorize release of their dental records.
Depression Anxiety Stress Scale-21
The Depression Anxiety Stress Scale-21 (DASS-21) measures depression, anxiety, and stress severity, with scoring and validated severity bands.
Depression Anxiety Stress Scale, Youth
The DASS-Y is a 21-item self-report scale measuring depression, anxiety, and stress in youth. See scoring, severity cutoffs, and administration tips.
Epworth Sleepiness Scale
The Epworth Sleepiness Scale (ESS) is an 8-item questionnaire measuring daytime sleepiness. See scoring, the 0 to 24 range, and severity bands.
Experiences in Close Relationships, Revised
The ECR-R (Experiences in Close Relationships-Revised) is a 36-item self-report measure of adult attachment anxiety and avoidance.
Fatigue Severity Scale
The Fatigue Severity Scale (FSS) is a 9-item questionnaire measuring how fatigue affects daily functioning, with scoring, cutoffs, and administration tips.
Foot and Ankle Disability Index
Foot and Ankle Disability Index (FADI): a 26-item self-report scale of foot and ankle function and pain, scored 0 to 100%.
Functional Assessment Short Test
The Functioning Assessment Short Test (FAST) is a 24-item scale measuring daily functioning across six domains in bipolar disorder.
General Consent for Medical Treatment
The General Consent for Medical Treatment form documents a patient's permission for routine care, plus HIPAA and financial acknowledgments.
Geriatric Depression Scale, 15-item
The GDS-15 is a 15-item yes/no depression screen for older adults. Zentake scores it automatically and has results ready before the visit.
Hamilton Anxiety Rating Scale
The HAM-A (Hamilton Anxiety Rating Scale) is a 14-item clinician-rated measure of anxiety severity, scored 0 to 56. See scoring, cutoffs, and best practices.
Immunization Consent
Immunization Consent form template: collect screening, VIS acknowledgment, and e-signed authorization before the visit with Zentake.
Informed Consent, Female Testosterone and/or Estradiol Pellet Insertion
Informed Consent, Female Testosterone and/or Estradiol Pellet Insertion template: collect risks, alternatives, and e-signatures before the visit.
Informed Consent, GLP-1 Agonist
GLP-1 agonist informed consent form template for med spas: covers semaglutide and tirzepatide risks, benefits, and patient sign-off.
Informed Consent, Male Testosterone Pellet Insertion
The Informed Consent, Male Testosterone Pellet Insertion form documents risks, benefits, and consent for male testosterone pellet therapy.
Instrumental Activities of Daily Living Scale
The Lawton Instrumental Activities of Daily Living (IADL) Scale rates independence across eight everyday tasks to track functional decline in older adults.
International Prostate Symptom Score
The International Prostate Symptom Score (I-PSS) is a 7-item questionnaire rating lower urinary tract symptom severity and quality of life in men.
International Trauma Questionnaire
The ITQ (International Trauma Questionnaire) is an 18-item ICD-11 self-report measure for PTSD and complex PTSD. Scoring, uses, and best practices.
Laser Hair Removal Informed Consent
The Laser Hair Removal Informed Consent documents treatment risks, alternatives, and patient agreement before laser sessions at a med spa.
Lower Extremity Functional Scale
20-item outcome measure for lower-extremity musculoskeletal conditions. Auto-scored for baseline and progress tracking.
Massage Therapy Intake Form
The Massage Therapy Intake Form collects health history, goals, and consent so massage practices can plan safe, effective sessions.
McLean Screening Instrument for BPD
The McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) is a 10-item yes/no screen for borderline personality disorder.
Medical Insurance Verification Form
The Medical Insurance Verification Form confirms a patient's coverage, benefits, and costs before the visit. Free HIPAA-ready template from Zentake.
Medical Symptoms Questionnaire
The Medical Symptoms Questionnaire (MSQ) scores symptom burden across body systems. Learn how the MSQ works, its 0-4 scale, and score interpretation.
Mental Health Session / Therapy Notes
Mental Health Session / Therapy Notes template for documenting therapy sessions in a structured, HIPAA-aware progress note format.
Michigan Alcohol Screening Test
The Michigan Alcohol Screening Test (MAST) is a 24-item screen for lifetime alcohol problems. See scoring, cutoffs, and how Zentake automates it.
Michigan Alcohol Screening Test, Geriatric
The MAST-G (Michigan Alcohol Screening Test, Geriatric) is a 24-item yes or no screen for alcohol misuse in older adults. Scoring, cutoffs, and uses.
Modified Checklist for Autism in Toddlers, Revised
Autism screener for toddlers 16 to 30 months, with structured follow-up for at-risk responses.
Mood Disorder Questionnaire
Mood Disorder Questionnaire (MDQ): a 13-item bipolar spectrum screen. See scoring, the positive-screen criteria, and administration tips.
Notice of Privacy Practices Acknowledgment
Notice of Privacy Practices Acknowledgment template: what it includes, how to collect it, and a digital vs paper comparison.
OB-GYN Patient History Form
OB-GYN Patient History Form template: capture menstrual, obstetric, gynecologic, and sexual health history before the visit.
Patient Financial Responsibility Agreement
Patient Financial Responsibility Agreement template: fields, uses, and how to collect it digitally with Zentake before the visit.
Patient Health Questionnaire-2
The PHQ-2 is a two-item depression screener scored 0 to 6. See how it works, how to score it, and how Zentake delivers it before the visit.
Patient Satisfaction Survey
The Patient Satisfaction Survey measures care experience on a 5-point Likert scale across domains like communication, access, and time with the provider.
Pelvic Floor Impact Questionnaire-7
The PFIQ-7 (Pelvic Floor Impact Questionnaire-7) measures how urinary, bowel, and prolapse symptoms affect quality of life, scored 0 to 300.
Perceived Stress Scale-10
The Perceived Stress Scale-10 (PSS-10) is a 10-item measure of perceived stress. Score and send it before the visit with Zentake.
Perinatal Anxiety Screening Scale
The Perinatal Anxiety Screening Scale (PASS) is a 31-item screen for anxiety in pregnancy and postpartum. See scoring, bands, and how Zentake automates it.
Pittsburgh Insomnia Rating Scale-20
The Pittsburgh Insomnia Rating Scale-20 (PIRS-20) is a 20-item self-report measure of insomnia severity.
Professional Quality of Life Scale
The Professional Quality of Life Scale (ProQOL) measures compassion satisfaction, burnout, and secondary traumatic stress in helping professionals.
PROMIS Global Health-10
The PROMIS-10 is a 10-item patient-reported measure of overall physical and mental health, reported as physical and mental health T-scores.
Provider Referral Form
A Provider Referral Form template that captures patient, referring provider, and reason-for-referral details for a smooth handoff.
Psychiatric Evaluation Form
The Psychiatric Evaluation Form captures mental health history, symptoms, and a mental status exam so clinicians can assess and plan care.
PTSD Checklist for DSM-5
20-item PTSD screening instrument with optional Life Events Checklist prequel. Auto-scored and in the public domain.
Rapid Mood Screener
The Rapid Mood Screener (RMS) is a 6-item yes or no screen that helps distinguish bipolar I disorder from major depressive disorder in adults.
Refusal of Recommended Immunizations
Refusal of Recommended Immunizations template: document a parent or patient declining vaccines, for pediatric and family practices.
Screen for Child Anxiety Related Disorders, Parent
The SCARED Parent is a 41-item screen that helps identify panic, generalized, separation, and social anxiety in children aged 8 to 18.
Self-Administered Alcoholism Screening Test, Revised
The SAAST-R (Self-Administered Alcoholism Screening Test, Revised) screens adults for alcohol-related problems with brief yes or no questions.
Short Michigan Alcohol Screening Test
The Short Michigan Alcohol Screening Test (SMAST) is a 13-item yes/no screen for possible alcohol problems. See scoring, cutoffs, and uses.
Suicide Behaviors Questionnaire, Revised
The Suicide Behaviors Questionnaire-Revised (SBQ-R) is a validated 4-item screener for suicide risk. See scoring, cutoffs, and how Zentake automates it.
Telehealth Behavioral Consent
Telehealth Behavioral Consent documents client agreement to virtual mental health care, covering privacy, technology risks, and emergency protocols.
Tobacco, Alcohol, Prescription Medication and Other Substance Use Tool
The TAPS Tool is a two-part screen for tobacco, alcohol, prescription medication, and other substance use in adult primary care patients.
Vanderbilt ADHD Diagnostic Rating Scale
The Vanderbilt ADHD Diagnostic Rating Scale is a free parent and teacher ADHD screener for children 6 to 12. See items, scoring, and cutoffs.
Wender Utah Rating Scale
The Wender Utah Rating Scale (WURS-25) is a 25-item retrospective self-report that helps adults recall childhood ADHD symptoms.
Zung Self-Rating Anxiety Scale
The Zung Self-Rating Anxiety Scale (SAS) is a 20-item self-report anxiety severity tool. Learn scoring, index cutoffs, and clinical uses.
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Template questions, answered.
Can I preview a template before signing up?
Yes. Every template in the library can be previewed in full before you create an account, and you can build from any of them during your trial.
Are the templates HIPAA compliant?
Yes. Forms built from these templates run on Zentake’s HIPAA-compliant platform with encryption and audit trails, and align with SOC 2, GDPR, and PIPEDA.
Can I customize a template?
Yes. Every template is a starting point. Add, remove, or reorder fields, apply conditional logic and validation, and brand it to your practice.
Do patients need an account to complete a form?
No. Patients complete forms from a secure link on any device, or on an in-clinic tablet, with nothing to download and no account to create.
Are the clinical scales the validated versions?
Yes. Screeners like the PHQ-9 and GAD-7 use the standard validated items and scoring, auto-scored the moment a patient submits.
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