Substance Use Screening (CAGE-AID)
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Substance Use Screening (CAGE-AID)
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The Substance Use Screening form provides a structured approach to screening for alcohol and drug use disorders based on the CAGE-AID (Cut down, Annoyed, Guilty, Eye-opener -- Adapted to Include Drugs) framework. This validated screening tool helps identify patients who may benefit from further evaluation or treatment for substance use disorders.
Beyond the core CAGE-AID questions, this template includes frequency and quantity assessment for common substance categories (alcohol, tobacco, cannabis, prescription misuse, and illicit drugs), impact evaluation on work, relationships, and health, and a readiness-for-change assessment. The frequency questions use standardized intervals that align with AUDIT-C and NIDA screening recommendations.
The form is designed with sensitivity, using non-judgmental language and optional response fields where appropriate. Confidentiality assurances are prominent, noting that substance use information receives additional federal protections under 42 CFR Part 2. This template is used in primary care annual screenings, behavioral health intakes, emergency department SBIRT (Screening, Brief Intervention, Referral to Treatment) programs, and pre-surgical assessments.
What's included
- CAGE-AID validated screening questions
- Substance frequency and quantity assessment
- Impact evaluation on work, health, relationships
- Readiness-for-change assessment
- 42 CFR Part 2 confidentiality acknowledgment
- Referral and resource documentation
Who uses this template
- Primary care annual substance use screening
- Behavioral health and addiction intake
- Emergency department SBIRT programs
- Pre-surgical substance use assessment
All form fields
11 fields across 2 pages. Customize any field after signing up.
How to use the Substance Use Screening (CAGE-AID)
Getting started with this template takes just a few minutes. Sign up for a free Formisoft trial, then select the Substance Use Screening (CAGE-AID) 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 Substance Use Screening (CAGE-AID) in the template library and click “Use this template” to add it to your account.
- 2Customize fields. Add, remove, or reorder any of the 11 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 Substance Use Screening (CAGE-AID) HIPAA compliant?
Yes. All Formisoft templates, including the Substance Use Screening (CAGE-AID), 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 11 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 Substance Use Screening (CAGE-AID) 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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