Page History
Frequency of Administration for Clinical Visits
Form Name | First Visit | Subsequent Visit(Less than 7 days) | Subsequent Visit(8 days +; less than 30 days) | Subsequent Visit(30 days or more) |
|---|---|---|---|---|
| Registration Form | ✓ | - | - | - |
Before and/or While Client is Receiving Services | ||||
| Service Request Form (SERVICE_REQUEST)* | ✓ | ✓ | ✓ | ✓ |
Start of Visit Form (START_VISIT)*
| ✓ | ✓ | ✓ | ✓ |
| Consent - Youth (CONSENT) | ✓ | - | - | - |
| Reason for Visit (REASON_VISIT) | ✓ | ✓ | ✓ | ✓ |
| Demographic Survey - Youth (DEMO) | ✓ | - | - | ✓ |
Kessler Psychological Distress Scale (K10) | - | - | - | -✓ |
| K10 (Past Week) (K10W) | ✓ | - | -✓ | - |
| Self-Rated Health (SRH) | ✓ | - | -✓ | -✓ |
| Self-Rated Mental Health (SRMH) | ✓ | - | -✓ | -✓ |
| Global Appraisal of Individual Needs: Short Screener (GAIN-SSS) | ✓ | - | - | -✓ |
| Outcome Questionnaire - 45 (OQ-45) | - | - | -✓ | - |
| Goal-Based Outcomes (GBO) | ✓ | - | ✓ | ✓ |
| Patient Health Questionnaire (PHQ-9) | ✓ | - | -✓ | -✓ |
| Session Rating Scale (SRS) | ✓ | ✓ | ✓ | ✓ |
| Columbia - Suicide Severity Rating Scale (C-SSRS)*+ | ✓ | - | -✓ | -✓ |
| GAIN-SS (GAIN_SS) | OPTIONAL | OPTIONAL | OPTIONAL | OPTIONAL |
After Client Has Received Services | ||||
End of Visit Form (END_VISIT)*
| ✓ | ✓ | ✓ | ✓ |
| Satisfaction with Services (SATISFACTION) | ✓ | ✓ | ✓ | ✓ |
Legend: * Form is completed by service provider + Form only completed if youth identified suicide ideation in the PHQ-9, GAIN-SS, or anytime at the discretion of the clinician. Note: At the discretion of the service provider, any tool can be administered within less than 7 days, if helpful for service provision. | ||||
Click here to download a printable version of this document:
| View file | ||||
|---|---|---|---|---|
|
