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PTSD Checklist (PCL-5) Screening

Asks about date of screening, brief trauma description, and repeated, disturbing memories. Built for behavioral health and trauma therapy intake and monitoring.

Questions
14
Pages
2
Time
about 4 min
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Your practice

PTSD Checklist (PCL-5) Screening

Page 1 of 2 · Your information

Live preview. Tap through it like a patient.

Who it is for

  • 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

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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. Brief Trauma DescriptionLong Text
  4. Repeated, disturbing memoriesLong Text
  5. Repeated, disturbing dreamsLong Text

Page 2 · Additional details

  1. Avoiding external remindersLong Text
  2. Negative beliefs about yourself or the worldLong Text
  3. Loss of interest in activitiesLong Text
  4. Feeling irritable or angryLong Text
  5. Difficulty concentratingLong 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 PTSD Checklist (PCL-5) Screening, 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.

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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 PTSD Checklist (PCL-5) Screening for your practice, ready to send before the next visit.

BAA included · We set up your front desk

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