bhworks has a large library of forms, assessments, and screeners that can be completed electronically on the platform. These include forms that can be completed by staff, participants, parents/guardians, and teachers.
The document linked below provides a list of all forms currently available and their respective use or domain. If you would like access to any of these tools, please contact support@mdlogix.com for assistance.
All example report were completed with test student data to demonstrate results that would be similar to results if conducted on an actual student.
For an additional cost, mdlogix can also create custom forms for you organization. To get a quote, please email support@mdlogix.com with a copy of the form that you would like for a quote. Depending on the licensure, some forms cannot be created on bhworks due to copyright or licensing requirements.
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| Form Name | Domain/Application | Example Report Link |
| BEHAVIORAL HEALTH SCREEN VERSIONS | ||
| Behavioral Health Screen - Adult | Multi-Domain | Behavioral Health Screen - Adult |
| Behavioral Health Screen - PC 12 to 24 | Multi-Domain | Behavioral Health Screen - PC 12 to 24 |
| Behavioral Health Screen - PC 25 and above | Multi-Domain | Behavioral Health Screen - PC 25 and above |
| Behavioral Health Screen - School 12 to 24 | Multi-Domain | Behavioral Health Screen - School 12 to 24 |
| Behavioral Health Screen for Ages 6-14 (Parent Report) | Multi-Domain | Behavioral Health Screen for Ages 6-14 (Parent Report) |
| Behavioral Health Screen - 3rd Party Report | Multi-Domain | Behavioral Health Screen - 3rd Party Report |
| Behavioral Health Screen - Mobile Crisis | Multi-Domain | |
| ACADEMICS | ||
| Academic Plan | Academic Improvement | Academic Plan |
| College Readiness Assessment | Secondary Education Preparedness | College Readiness Assessment |
| ALCOHOL USE DISORDER | ||
| Alcohol Use Disorders Identification Test (AUDIT) | Alcohol | Alcohol Use Disorders Identification Test (AUDIT) |
| Alcohol Use Disorders Identification Test (AUDIT-C) | Alcohol | Alcohol Use Disorders Identification Test (AUDIT-C) |
| ANXIETY | ||
| Generalized Anxiety Disorder (GAD 7) | Anxiety | Generalized Anxiety Disorder (GAD 7) |
| Generalized Anxiety Disorder (GAD-C 11-17) | Anxiety | Generalized Anxiety Disorder (GAD-C 11-17) |
| Screen for Child Anxiety Related Disorders (SCARED) - Child Report | Anxiety | Screen for Child Anxiety Related Disorders (SCARED) - Child Report |
| Screen for Child Anxiety Related Disorders (SCARED) - Parent Report | Anxiety | Screen for Child Anxiety Related Disorders (SCARED) - Parent Report |
| CLASSROOM BEHAVIORS | ||
| Student Risk Screening Scale - Internalizing and Externalizing (SRSS-IE) MS/HS | Internalizing and Externalizing Behaviors | Student Risk Screening Scale - Internalizing and Externalizing (SRSS-IE) MS/HS |
| Student Risk Screening Scale - Internalizing and Externalizing (SRSS-IE) Elementary | Internalizing and Externalizing Behaviors | Student Risk Screening Scale - Internalizing and Externalizing (SRSS-IE) Elementary |
| Student Risk Screening Scale - Internalizing and Externalizing (SRSS-EC) Early Childhood | Internalizing and Externalizing Behaviors | Student Risk Screening Scale - Internalizing and Externalizing Early Childhood (SRSS-EC) |
| Teacher Observation of Classroom Adaptation - Checklist (TOCA-C) | Social-emotional, behavioral, and family | Teacher Observation of Classroom Adaptation - Checklist (TOCA-C) |
| CONSENTS and RELEASE DOCUMENTATION | ||
| Consent for Community Referral | Consent for External Referrals | |
| Consent for Individual Screening | Indicated Student Screening Consent | Consent to Individual Screening |
| Consent to School-Based Services and Medicaid Billing | Consent to Student Services and Medicaid Reimbursement | Consent to School-Based Services and Medicaid Billing |
| Consent for Supervision | Consent for Limited License Staff | |
| Consent to Universal Screening | Consent to Participate in Universal Screening | Consent to Universal Screening |
| Release of Information | Authorization to Receive/Release Information | |
| CRISIS INTERVENTION | ||
| Crisis Support Response Plan | Student Risk Safety Plan | Crisis Support Response Plan |
| Crisis Response Log | Crisis Referral Information and Outcomes | Crisis Response Log |
| DEPRESSION | ||
| Patient Health Questionnaire (PHQ) | Depression | Patient Health Questionnaire (PHQ) |
| Patient Health Questionnaire Adolescent (PHQ-A) | Depression | Patient Health Questionnaire Adolescent (PHQ-A) |
| PROMIS Depression Short-Form | Depression | PROMIS Depression Short-Form |
| Short Mood & Feelings Questionnaire - Self-Report | Depression | Short Mood & Feelings Questionnaire - Self Report |
| Short Mood & Feelings Questionnaire - Parent Report | Depression | Short Mood & Feelings Questionnaire - Parent Report |
| FAMILY & RELATIONSHIPS | ||
| Experience in Close Relationships | Family Support & Relationships | Experience in Close Relationships |
| GAMBLING | ||
Lie Bet Screening for Problem Gambling | Gambling | |
| GRANT REPORTING - STATE & FEDERAL | ||
| GPRA Intake | Government Performance and Results Act (SAMHSA) | GPRA Intake |
| GPRA Mid-Treatment | Government Performance and Results Act (SAMHSA) | |
| GPRA Discharge | Government Performance and Results Act (SAMHSA) | |
| NOMS Baseline Interview - Adult | Government Performance and Results Act (SAMHSA) | NOMS Baseline Interview |
| NOMS Reassessment Interview - Adult | National Outcomes Measures | NOMS Reassessment Interview |
| NOMS Discharge Interview - Adult | National Outcomes Measures | NOMS Discharge Interview |
| NOMS Baseline Interview - Child | National Outcomes Measures | NOMS Baseline Interview - Child |
| NOMS Reassessment Interview - Child | National Outcomes Measures | NOMS Reassessment Interview - Child |
| NOMS Discharge Interview - Child | National Outcomes Measures | NOMS Discharge Interview - Child |
| Student Assistance Program File 2.0 (JQRS) | Grant Reporting for Student Assistance Program | Student Assistance Program File 2.0 (JQRS) |
| LONELINESS & SOCIAL ISOLATION | ||
| De Jong Gierveld Loneliness Scale - Brief | Social and Emotional Loneliness | De Jong Gierveld Loneliness Scale - Brief |
| De Jong Gierveld Loneliness Scale - Extended | Social and Emotional Loneliness | |
| MENTAL / PHYSICAL IMPAIRMENT | ||
| Functional Assessment Form | Mental / Physical Impairment | Functional Assessment Form |
| MULTI-DOMAIN ASSESSMENTS - CHILD & ADOLESCENTS | ||
| Child and Adolescent Needs and Strengths (CANS) | Multi-Domain Clinical Observation | Child and Adolescent Needs and Strengths (CANS) |
| Pediatric Symptoms Checklist (PSC 35) - Youth Report | Internalizing, Externalizing, and Attention Behaviors | Pediatric Symptom Checklist (PSC 35) - Youth Report |
| Pediatric Symptoms Checklist (PSC 35) - Parent Report | Internalizing, Externalizing, and Attention Behaviors | Pediatric Symptoms Checklist (PSC 35) - Parent Report |
| Pediatric Symptom Checklist (PSC 17) - Youth Report | Internalizing, Externalizing, and Attention Behaviors | Pediatric Symptom Checklist (PSC 17) Youth Report |
| Pediatric Symptoms Checklist (PSC 17) - Parent Report | Internalizing, Externalizing, and Attention Behaviors | Pediatric Symptom Checklist (PSC-17) - Parent Report |
| HEADS-E (Home, Education, Activities, Drugs, Suicidality, Emotions, Discharge) | Multi-Domain | HEADS-E (Home, Education, Activities, Drugs, Suicidality, Emotions, Discharge) |
| SLEEP / INSOMNIA | ||
| Insomnia Severity Index | Insomnia / Sleep Problems | Insomnia Severity Index |
| Pittsburgh Sleep Quality Index | Sleep | |
| SOCIAL EMOTIONAL LEARNING | ||
| Social Emotional Competency Assessment (Short) | Social Emotional Learning | Social Emotional Competency Assessment - Short Form (WCSD-SECA) |
| Social Emotional Competency Assessment (Long) | Social Emotional Learning | Social Emotional Competency Assessment - Long Form (WCSD-SECA) |
| SOCIAL DETERMINANTS OF HEALTH | ||
| Social Determinants Questionnaire Parent | Social Determinants of Health | Social Determinants Questionnaire Parent |
| Social Determinants Questionnaire Child | Social Determinants of Health | Social Determinants Questionnaire Child |
| SEDH Screening Tool | Social Environmental Determinants of Health | |
| STRESS | ||
| Perceived Stress Scale | Stress | Perceived Stress Scale |
| STUDENT MENTAL HEALTH SUPPORT | ||
| Biopsychosocial Assessment (BPSA) | Biopsychosocial Assessment | Biopsychosocial Assessment (BPSA) |
| Plan of Care | Student Treatment Planning | Plan of Care |
| Academic Plan | Academic Improvement | Academic Plan |
| Functional Behavior Assessment | Behavior Assessment | Functional Behavior Assessment |
| Student Assistance Program Tracking Form | Student Counseling | |
| Discharge Summary | Therapy Discharge | Discharge Summary |
| STUDENT 504 DOCUMENTS | ||
| Section 504 - Referral Form | Section 504 | Section 504 - Referral Form |
| Section 504 - Evaluation/Placement Checklist | Section 504 | Section 504 - Evaluation/Placement Checklist |
| Section 504 - Evaluation Consent | Section 504 | Section 504 - Evaluation Consent |
| Section 504 - Parent Input | Section 504 | Section 504 - Parent Input |
| Section 504 - Eligibility Determination Report | Section 504 | Section 504 - Eligibility Determination Report |
| Section 504 - Plan | Section 504 | Section 504 - Plan |
| Section 504 - Prior Written Notice | Section 504 | Section 504 - Prior Written Notice |
| Section 504 - Manifestation Determination | Section 504 | Section 504 - Manifestation Determination |
| SUBSTANCE USE INCLUDING ALCOHOL AND TOBACCO | ||
| Brief Addiction Monitor-Revised (BAM-R) | Substance Use | Brief Addiction Monitor-Revised (BAM-R) |
| Drug Abuse Screening Test (DAST-10) | Substance Use | Drug Abuse Screening Test (DAST-10) |
| Simple Screen for Substance Abuse | Substance Use | Simple Screen for Substance Abuse - Clinical Interview |
| CAGE-AID | Substance Use including Alcohol | CAGE-AID |
| NIDA Quick Screen | Substance Use - Adults | NIDA Quick Screen |
| NIDA-Modified ASSIST | Substance Use - Adults | |
| Addiction Severity Index-5th Edition | Substance Use Addiction | |
| CRAFFT 2.1 | Substance-related Risks (Adolescents) | CRAFFT 2.1 |
| CRAFFT 2.1N | Substance-related Risks including Vaping (Adolescents) | CRAFFT 2.1N |
| Chemical Dependency Evaluation | Substance Use | Chemical Dependency Evaluation |
| Overdose Questionnaire | Narcotics Overdose History | |
| Penn State Electronic Cigarette Dependence Index | Tobacco Use | Penn State Electronic Cigarette Dependence Index |
| Penn State Cigarette Dependence Index | Tobacco Use | |
| The Tobacco, Alcohol, Prescription medications, and other Substance (TAPS) Tool | Substance Use including Nicotine | The Tobacco, Alcohol, Prescription medications, and other Substance (TAPS) Tool |
| SUICIDE IDEATION | ||
| Ask Suicide-Screening Questions (ASQ) | Suicide Ideation | Ask Suicide-Screening Questions |
| Columbia-SSRS - Clinician Report | Suicide Ideation - Clinician Report | Columbia-SSRS (Clinician Report) |
| Columbia-SSRS-ED Self Report | Suicide Ideation - Patient Self Report | |
| Safety Plan Template | Suicide Risk Treatment Plan | Safety Plan Template |
| Summer Plan | Suicide Ideation Management | Summer Plan |
| CAMS Therapeutic Worksheet | Suicide Treatment Plan | |
| CAMS SSF4 Initial Session | Suicide Treatment Plan | CAMS SSF4 Initial Session |
| CAMS SSF4 Interim Session | Suicide Treatment Plan | CAMS SSF4 Interim Session |
| CAMS SSF4 Final Session | Suicide Treatment Plan | CAMS SSF4 Final Session |
| THREAT ASSESSMENT DOCUMENTATION | ||
| Threat Assessment - Observations for Intervention | Threat Assessment | Observations for Intervention |
| Threat Assessment - Report, Assessments, Observations, and Classification | Threat Assessment | Report, Assessments, Observations, and Classification |
| Threat Assessment - Target or Witness Interview | Threat Assessment | Target or Witness Interview |
| Threat Assessment - Threatener Interview | Threat Assessment | Threatener Interview |
| TRAUMA | ||
| ACEs Adverse Childhood Experiences | Traumatic Experiences | ACEs Adverse Childhood Experiences |
| ACEs for Adults | Traumatic Experiences | ACEs for Adults |
| ACE-Q Child Parent Report | Traumatic Experiences | ACE-Q Child Parent Report |
| ACE-Q Teen Self-Report | Traumatic Experiences | ACE-Q Teen Self-Report |
| ACEs Positive Childhood Experiences | Traumatic Experiences | ACEs Positive Childhood Experiences |
| ACEs: Resilience | Traumatic Experiences | ACEs: Resilience |
| Child and Adolescent Trauma Screening (CATS) | Traumatic Experiences | Child and Adolescent Trauma Screen (CATS) - Youth Report |
| Life Events Checklist (LEC-5E) for DSM-5 | Personal / Environmental Trauma | |
| USABILITY & UTILITY | ||
| BHS in Schools Usability Survey | Project / Organization Readiness | BHS in Schools Usability Survey |
| Usability and Utility Questionnaire | Software Focus Groups | |
| WELL-BEING | ||
| Student Subjective Wellbeing Questionnaire (SSWQ) | Well-Being | Student Subjective Wellbeing Scale |
| WHO (Five) Well-Being Index | Well-Being | WHO (Five) Well-Being Index |
| PCL-C | Emotional / Well-Being | PCL-C |
| Self Report Quality of Life | Quality of Life | |
| ASSESSMENT BATTERIES | ||
| PHQ-AuditC-GAD | Depression, Alcohol, and Anxiety | PHQ-AuditC-GAD |
| PHQ-GAD | Depression and Anxiety | PHQ-GAD |
| PHQ-GAD Adolescent | Depression and Anxiety | PHQ-GAD Adolescent |
| PHQ-CRAFFT 2.1N Adolescent | ||
| PHQ-AuditC | Depression and Alcohol | PHQ-AuditC |
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