formisoft

DAST-10 Drug Abuse Screening Test

Asks about date of screening, used drugs other than for medical reasons, and abused prescription drugs. Built for primary care routine drug use screening within SBIRT protocols.

Questions
14
Pages
2
Time
about 4 min
Use this templatePrint it instead

Your practice

DAST-10 Drug Abuse Screening Test

Page 1 of 2 · Your information

Live preview. Tap through it like a patient.

Who it is for

  • Primary care routine drug use screening within SBIRT protocols
  • Behavioral health and addiction treatment intake assessment
  • Pain management clinic opioid misuse risk evaluation
  • Employee assistance and workplace wellness programs

Formisoft for Mental Health

What's inside

Before you publish: 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.

Page 1 · Your information

  1. Patient NameText · Required
  2. Date of ScreeningDate
  3. Used drugs other than for medical reasons?Long Text
  4. Abused prescription drugs?Long Text
  5. Able to stop using drugs when you want?Long Text

Page 2 · Additional details

  1. Spouse or family complains about drug use?Long Text
  2. Neglected family or responsibilities?Long Text
  3. Engaged in illegal activities for drugs?Long Text
  4. Withdrawal symptoms from drugs?Long Text
  5. Medical problems from drug use?Long Text

From form to a ready patient

  1. The Formisoft form builder with editable questions and required toggles

    01

    Make it yours

    Reword, reorder, or add to the DAST-10 Drug Abuse Screening Test, and add your logo.

  2. A patient filling out a Formisoft form on a phone

    02

    Patients finish it at home

    A secure link by text or email, filled out on their phone before the visit. No app.

  3. The Formisoft dashboard showing how many of today's patients are ready

    03

    Your team sees who is ready

    Each visit shows as ready once its forms are in. Answers land on the patient record.

Related templates

All templates

Questions

Responses are encrypted, only your team can see them, and a BAA is included.

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

Yes. Attach the form to a visit type and every patient who books gets it right away, with a reminder before the visit if it is not done. Your calendar shows which visits are ready.

Send it before the visit, so patients arrive ready.

Book a short call and we will set up the DAST-10 Drug Abuse Screening Test for your practice, ready to send before the next visit.

BAA included · We set up your front desk

Use this template