Intake Form Library

Intake Form Library

Intake Form Library

Healthquest has an extensive list of intake forms that are available to all clinics that utilize the feature. The list of public intake forms is below, new forms are added often, so check back regularly. 

Public Intake Forms

*Updated May 12, 2025
  1. ADHD Rating Scale IV - Preschool Version
  2. ADHD RS-IV with Adult Prompts
  3. Adolescent Autism Spectrum Quotient (AQ)
  4. Adult AHDH Self Report
  5. AHS Database 1 and 2
  6. Asthma Control Test (ACT)
  7. Back Bournemouth Questionnaire
  8. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)
  9. Behavior Rating Inventory of Executive Function (BRIEF) - Adult Version
  10. Brief Michigan Hand Outcomes Questionnaire (Brief MHQ)
  11. Brief Pain Inventory
  12. Burn's Depression Checklist
  13. Canadian Chiropractic Protective Association - Consent to Chiropractic Treatment
  14. Carpal Tunnel Syndrome Questionnaire (CTSQ)
  15. Childhood Autism Spectrum Test (CAST)
  16. COPD Assessment Test (CAT)
  17. COVID-19 Assessment
  18. CPSA Practice Readiness Assessment Patient Consent
  19. Eating Disorder Diagnostic Scale
  20. Electronic Consent
  21. EQ-5D-5L
  22. Fitzpatrick Skin Type Tester
  23. Food Allergy Quality of Life Questionnaire - Parent Form (FAQoL-PF) for Children 0-3
  24. Food Allergy Quality of Life Questionnaire - Parent Form (FAQoL-PF) for Children 4-6
  25. Food Allergy Quality of Life Questionnaire - Parent Form (FAQoL-PF) for Children 7-12
  26. GAD-7
  27. Generic Vaccine Consent Form
  28. Get Active Questionnaire
  29. Headache Impact Test (HIT-6)
  30. Influenza (Flu) Vaccine Consent Form
  31. LEFS
  32. Mood Disorder Questionnaire
  33. Neck Bournemouth Questionnaire
  34. Oral Immunotherapy Gastrointestinal (OIT GI) Questionnaire
  35. PaCT Care Plan
  36. Pain Catastrophizing Scale
  37. Pain Rating Scale
  38. ParQPlus2022
  39. Patient Rated Wrist Evaluation
  40. Pediatric Symptom Checklist-17 (PSC-17)
  41. Pediatric Symptom Checklist-17 (PSC-17) - child
  42. PHQ-9 modified for Adolescents (PHQ9A)
  43. QuickDASH Outcome Measure
  44. Rheum Info Health Assessment Questionnaire-II (HAQ-II)
  45. SCARED - Child Version
  46. SCARED - Adult Version
  47. SNAP-IV 26
  48. The Burns Anxiety Inventory
  49. The Migraine Disability Assessment Test
  50. The Patient Health Questionnaire (PHQ-9)
  51. Vanderbilt AHDH - Parent
  52. Visual Analogue Scale - Hand/Wrist
  53. Wender Utah Rating Scale for ADHD
  54. WOMAC Pain Score for OA
  55. Zung Anxiety Assessment Tool

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