Suicide Risk Assessment (Columbia Protocol)
Assessment

Suicide Risk Assessment (Columbia Protocol)

2 pages•16 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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Suicide Risk Assessment (Columbia Protocol)

Suicide Risk Assessment (Columbia Protocol)

Page 1 of 2

Full Name
Jane Martinez
Assessment Date & Setting
03/15/1985
Suicidal Ideation Severity
Enter details here...
Ideation Intensity (Frequency/Duration)
Enter details here...
Intent to Act
Enter details here...
Specific Plan
Enter details here...
Preparatory Behaviors
Enter details here...
Lifetime Attempt History
Enter details here...
Recent Attempt Details
Enter details here...
Risk Factors
Enter details here...
Protective Factors
Enter details here...
Access to Lethal Means
Enter details here...
Safety Plan
Enter details here...
Risk Level Determination
Enter details here...
Disposition/Referral
Enter details here...
Clinician Signature
Sign here
Submit
Use this template

Sign up and start customizing in minutes.

Start with the Suicide Risk Assessment (Columbia Protocol) template and tailor it to your practice. It includes 16 editable fields across 2 pages. Included questions: Full Name, Assessment Date & Setting, Suicidal Ideation Severity, Ideation Intensity (Frequency/Duration). 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

  • Full Name
  • Assessment Date & Setting
  • Suicidal Ideation Severity
  • Ideation Intensity (Frequency/Duration)
  • Intent to Act
  • Specific Plan
  • Preparatory Behaviors
  • Lifetime Attempt History
  • Recent Attempt Details
  • Risk Factors
  • Protective Factors
  • Access to Lethal Means
  • Safety Plan
  • Risk Level Determination
  • Disposition/Referral
  • Clinician Signature

Who uses this template

  • Emergency department psychiatric triage and suicide risk screening
  • Behavioral health intake and ongoing suicide risk monitoring using C-SSRS
  • Primary care universal suicide screening during depression and anxiety evaluations
  • Crisis intervention center assessment and safety planning documentation

All form fields

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

Full NameText
Assessment Date & SettingDate
Suicidal Ideation SeverityLong Text
Ideation Intensity (Frequency/Duration)Long Text
Intent to ActLong Text
Specific PlanLong Text
Preparatory BehaviorsLong Text
Lifetime Attempt HistoryLong Text
Recent Attempt DetailsLong Text
Risk FactorsLong Text
Protective FactorsLong Text
Access to Lethal MeansLong Text
Safety PlanLong Text
Risk Level DeterminationLong Text
Disposition/ReferralLong Text
Clinician SignatureE-Signature

How to use the Suicide Risk Assessment (Columbia Protocol)

Getting started with this template takes just a few minutes. Sign up for a Formisoft trial, then select the Suicide Risk Assessment (Columbia Protocol) 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 Suicide Risk Assessment (Columbia Protocol) 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 16 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 16 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 Suicide Risk Assessment (Columbia Protocol) 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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