Screening

Geriatric Depression Scale (GDS) Form

2 pages•15 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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Geriatric Depression Scale (GDS) Form

Page 1 of 2

Patient Name
Jane Martinez
Date of Birth
03/15/1985
Date of Screening
03/15/1985
Satisfied with Life
Enter details here...
Dropped Activities and Interests
Enter details here...
Feel Life is Empty
Enter details here...
Often Get Bored
Enter details here...
In Good Spirits Most of the Time
Enter details here...
Afraid Something Bad Will Happen
Enter details here...
Feel Helpless
Enter details here...
Prefer Staying Home
Enter details here...
Memory Problems
Enter details here...
Current Medications
GDS Total Score
0
Provider Notes
Enter details here...
Submit
Use this template

Sign up and start customizing in minutes.

Start with the Geriatric Depression Scale (GDS) Form template and tailor it to your practice. It includes 15 editable fields across 2 pages. Included questions: Patient Name, Date of Birth, Date of Screening, Satisfied with Life. 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
  • Date of Screening
  • Satisfied with Life
  • Dropped Activities and Interests
  • Feel Life is Empty
  • Often Get Bored
  • In Good Spirits Most of the Time
  • Afraid Something Bad Will Happen
  • Feel Helpless
  • Prefer Staying Home
  • Memory Problems
  • Current Medications
  • GDS Total Score
  • Provider Notes

Who uses this template

  • Routine depression screening at geriatric wellness visits
  • Nursing home and assisted living facility intake assessments
  • Home health visit mental health evaluations
  • Post-hospitalization mood screening for elderly patients

All form fields

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

Patient NameText
Date of BirthDate
Date of ScreeningDate
Satisfied with LifeLong Text
Dropped Activities and InterestsLong Text
Feel Life is EmptyLong Text
Often Get BoredLong Text
In Good Spirits Most of the TimeLong Text
Afraid Something Bad Will HappenLong Text
Feel HelplessLong Text
Prefer Staying HomeLong Text
Memory ProblemsLong Text
Current MedicationsMedications
GDS Total ScoreNumber
Provider NotesLong Text

How to use the Geriatric Depression Scale (GDS) Form

Getting started with this template takes just a few minutes. Sign up for a Formisoft trial, then select the Geriatric Depression Scale (GDS) Form 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 Geriatric Depression Scale (GDS) Form 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 15 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 15 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 Geriatric Depression Scale (GDS) Form 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

Sign up and start customizing the Geriatric Depression Scale (GDS) Form for your practice. Set up in minutes.

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