PTSD Checklist (PCL-5) Screening
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PTSD Checklist (PCL-5) Screening
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The PTSD Checklist for DSM-5 (PCL-5) is the gold-standard self-report measure for screening and monitoring post-traumatic stress disorder symptoms. This 20-item questionnaire corresponds directly to the four DSM-5 PTSD symptom clusters: intrusion (items 1-5), avoidance (items 6-7), negative alterations in cognition and mood (items 8-14), and marked alterations in arousal and reactivity (items 15-20). Each item is rated on a 0-4 severity scale (not at all, a little bit, moderately, quite a bit, extremely) based on how much the symptom has bothered the patient in the past month.
The digital form includes fields for the total severity score (range 0-80), with a provisional PTSD diagnosis suggested at a score of 31-33 or higher. In addition to the total score, cluster-level scoring allows clinicians to identify which symptom domains are most prominent, guiding treatment planning. The PCL-5 can be used with or without a specific index trauma identified using the Life Events Checklist (LEC-5) or Criterion A assessment, and this template includes an optional brief trauma identification section.
This template is essential for behavioral health and trauma therapy practices, Veterans Affairs and military health clinics, primary care settings implementing trauma screening, and employee assistance programs supporting first responders. The PCL-5 is developed and maintained by the National Center for PTSD at the U.S. Department of Veterans Affairs and is freely available for clinical use. It serves both as a screening tool and a treatment outcome measure, allowing clinicians to track symptom reduction over the course of therapy.
What's included
- All 20 validated PCL-5 items across four DSM-5 clusters
- Automatic total score and cluster-level scoring
- Provisional PTSD diagnostic interpretation
- Optional index trauma identification section
- Treatment outcome tracking over multiple administrations
- Provider notes and treatment planning documentation
Who uses this template
- Behavioral health and trauma therapy intake and monitoring
- Veterans Affairs and military health PTSD screening
- Primary care trauma-informed screening programs
- First responder and employee assistance program assessments
All form fields
14 fields across 3 pages. Customize any field after signing up.
How to use the PTSD Checklist (PCL-5) Screening
Getting started with this template takes just a few minutes. Sign up for a free Formisoft trial, then select the PTSD Checklist (PCL-5) Screening from the template library. The form is ready to use immediately, but you can customize every field, add your practice logo, and adjust the layout to match your workflow.
Setup steps
- 1Choose the template. Find the PTSD Checklist (PCL-5) Screening in the template library and click “Use this template” to add it to your account.
- 2Customize fields. Add, remove, or reorder any of the 14 fields. Set fields as required or optional based on your practice needs.
- 3Brand it. Upload your logo, pick your colors, and add a custom welcome message so patients see your practice identity.
- 4Share with patients. Send the form via SMS, email, or embed it on your website. Patients complete it on any device before their visit.
- 5Review submissions. Responses appear in your dashboard in real time. Patient records are created automatically from the data collected.
Frequently asked questions
Is the PTSD Checklist (PCL-5) Screening HIPAA compliant?
Yes. All Formisoft templates, including the PTSD Checklist (PCL-5) Screening, are HIPAA compliant. Data is encrypted with 256-bit AES at rest and TLS 1.3 in transit. A Business Associate Agreement (BAA) is included on every plan.
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?
Yes. Formisoft's workflow automation can send intake forms automatically when an appointment is booked. You can set the timing (e.g., 48 hours before the visit) and include reminders for patients who haven't completed it.
Does this template work on mobile devices?
Yes. The PTSD Checklist (PCL-5) 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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