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

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