Screening

CRAFFT Adolescent Substance Abuse Screening

2 pages•14 fields
Editable templateCustomize in minutes

Clinical review required: this worksheet does not calculate scores, diagnose, or recommend treatment. Confirm the questions and response options against your approved assessment protocol before use.

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CRAFFT Adolescent Substance Abuse Screening

Page 1 of 2

Patient Name
Jane Martinez
Date of Birth
03/15/1985
Age
0
Alcohol Use in Past 12 Months
Enter details here...
Cannabis Use in Past 12 Months
Enter details here...
Other Substance Use in Past 12 Months
Enter details here...
Ridden in a Car with impaired driver?
Enter details here...
Used substances to Relax?
Enter details here...
Used substances while Alone?
Enter details here...
Forget things while using substances?
Enter details here...
Family or friends told you to cut down?
Enter details here...
Gotten into Trouble while using?
Enter details here...
CRAFFT Total Score
0
Confidentiality Acknowledgment
Enter details here...
Submit
Use this template

Sign up and start customizing in minutes.

Start with the CRAFFT Adolescent Substance Abuse Screening template and tailor it to your practice. It includes 14 editable fields across 2 pages. Included questions: Patient Name, Date of Birth, Age, Alcohol Use in Past 12 Months. The full field list below shows what you will get when you add this template to your account.

Choose this template to open an editable form. Review the questions, keep only the information your practice needs, and add your branding. Preview the patient experience before sharing a link or embedding the form. Responses can be reviewed in Formisoft and exported as a PDF.

Clinical review required: this worksheet does not calculate scores, diagnose, or recommend treatment. Confirm the questions and response options against your approved assessment protocol before use.

What's included

  • Patient Name
  • Date of Birth
  • Age
  • Alcohol Use in Past 12 Months
  • Cannabis Use in Past 12 Months
  • Other Substance Use in Past 12 Months
  • Ridden in a Car with impaired driver?
  • Used substances to Relax?
  • Used substances while Alone?
  • Forget things while using substances?
  • Family or friends told you to cut down?
  • Gotten into Trouble while using?
  • CRAFFT Total Score
  • Confidentiality Acknowledgment

Who uses this template

  • Pediatric and adolescent annual well visits
  • School-based health center screenings
  • Adolescent medicine clinic intake assessments
  • College and university student health screenings

All form fields

14 fields across 2 pages. Customize any field after signing up.

Patient NameText
Date of BirthDate
AgeNumber
Alcohol Use in Past 12 MonthsLong Text
Cannabis Use in Past 12 MonthsLong Text
Other Substance Use in Past 12 MonthsLong Text
Ridden in a Car with impaired driver?Long Text
Used substances to Relax?Long Text
Used substances while Alone?Long Text
Forget things while using substances?Long Text
Family or friends told you to cut down?Long Text
Gotten into Trouble while using?Long Text
CRAFFT Total ScoreNumber
Confidentiality AcknowledgmentLong Text

How to use the CRAFFT Adolescent Substance Abuse Screening

Getting started with this template takes just a few minutes. Sign up for a Formisoft trial, then select the CRAFFT Adolescent Substance Abuse Screening from the template library. Review the included questions, customize your fields, and preview the form before sharing it.

Setup steps

  1. 1Choose the template. Find the CRAFFT Adolescent Substance Abuse Screening in the template library and click “Use this template” to add it to your account.
  2. 2Customize fields. Add, remove, or reorder any of the 14 fields. Set fields as required or optional based on your practice needs.
  3. 3Brand it. Upload your logo, pick your colors, and add a custom welcome message so patients see your practice identity.
  4. 4Share with patients. Send the form via SMS, email, or embed it on your website. Patients complete it on any device before their visit.
  5. 5Review submissions. Responses appear in your dashboard in real time. Patient records are created automatically from the data collected.

Frequently asked questions

How does Formisoft protect responses?

Formisoft provides secure form collection and a Business Associate Agreement (BAA). Your practice must review the form content, access permissions, and sharing workflow for its requirements.

Can I customize the fields in this template?

Absolutely. You can add, remove, reorder, or modify any of the 14 fields. You can also add conditional logic, new pages, file uploads, e-signatures, and payment fields.

How do patients fill out this form?

Patients receive a link via SMS, email, or QR code. They complete the form on their phone, tablet, or computer before their appointment. No app download required.

Can I send this form automatically before appointments?

With a plan that includes automation, you can configure workflows to send forms and reminders. Appointment-based sending requires the booking event to reach Formisoft.

Does this template work on mobile devices?

Yes. The CRAFFT Adolescent Substance Abuse Screening is fully responsive and works on any device. Most patients complete intake forms on their phone, so every template is optimized for mobile-first use.

Start with this template

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