Clinical Outcomes Assessment (COA)
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Adverse Childhood Experiences Questionnaire (ACE-Q)
10 - item questionnaire to assess your exposure to potentially traumatic experiences occurring from birth to age 18.
Critical CareAlcohol Use Disorders Identification Test - C (AUDIT-C)
A 3-item tool to screen for unhealthy alcohol use in patients who may not be alcohol-dependent.
Critical CareAlcohol Use Disorders Identification Test (AUDIT)
A 10-item tool to screen for hazardous alcohol use, harmful use, and alcohol dependence.
Family PracticeAmerican Shoulder and Elbow Surgeons (ASES) Shoulder Score
15-item assessment of shoulder pain and functional limitations in activities of daily living.
Emergency MedicineBehavioral Activity Rating Scale (BARS)
A 1-item rating scale to quantify a patient's level of agitation in acute care or psychiatric settings.
Mental HealthBrief Sexual Function Inventory (BSFI)
Assessment of male sexual function and any disturbance due to lower urinary tract symptoms (LUTS).
UrologyDecreased Sexual Desire Screener (DSDS)
5 question tool for women to help your clinician determine the cause of your loss of interest in sex.
Clinical NutritionDrug Abuse Screening Test (DAST-10)
A patient self-report questionnaire to screen for problematic drug use (excluding alcohol/tobacco).
Family PracticeFemale Sexual Function Index (FSFI)
Measures six domains of female sexual function: desire, arousal, lubrication, orgasm, satisfaction, and pain.
Family PracticeFoot and Ankle Ability Measure (FAAM)
Assesses functional limitations and disability related to foot and ankle conditions in daily activities and sports.
Family PracticeFoot and Ankle Disability Index (FADI)
Assess functional limitations of those with a variety of foot and ankle conditions
Family PracticeGeneral Anxiety Disorder (GAD-7)
Measure severity of anxiety
Family PracticeHip Outcome Score
Assess functional limitations related to hip pathology, specifically in active individuals undergoing surgery.
Mental HealthInternational Index of Erectile Function (IIEF)
Assesses ED and related male sexual functions: erectile, orgasmic, desire, intercourse/overall satisfaction using IIEF.
Mental HealthInternational Index of Erectile Function-6 (IIEF-6)
6-item quiz to identify erectile dysfunction and severity over the past 4 weeks.
Family PracticeInternational Prostate Symptoms Score (IPSS)
Used to quantify benign prostatic hyperplasia (BPH) & to monitor treatment success.
Mental HealthLocke-Wallace Marital Adjustment Test (MAT)
AKA the Short Marital Adjustment Test (SMAT) used to assess marital satisfaction and adjustment within married couples.
Family PracticeMarx Activity Rating Scale
Assess knee function & activity level, such as patients with knee ligament injuries (commonly ACL tears) or post surgery
Clinical Outcomes Assessment (COA)Medical Symptom/Toxicity Questionnaire (MSQ)
The MSQ assesses degree of symptomology associated with potential body toxicity burden.
Family PracticeMigraine Treatment Optimization Questionnaire-4 (mTOQ-4)
Measures effectiveness of current migraine treatment plan.
Hematology & OncologyNational Cancer Institute PRO-CTCAE
Evaluates symptomatic toxicity in patients on cancer clinical trials
Family PracticePatient Health Questionnaire-9 (PHQ-9) Adult
10 - item assessment tool for screening, diagnosing, monitoring and measuring the severity of depression.
Family PracticePelvic Floor Distress Inventory (PFDI - 20)
20- item, short form of the PFDI, to assess quality of life for women with pelvic floor conditions.
UrologyPeyronie's Disease Questionnaire (PDQ)
Evaluates symptoms & psychological effects in patients with PD who have had vaginal intercourse within the last 3 months
Mental HealthPittsburgh Agitation Scale (PAS)
4-item survey to monitor the severity of agitation associated with dementia based on direct observations of the patient.
SurgeryPostoperative Quality of Recovery (QoR-15)
15-item tool to measure the early postoperative health status of patients after anesthesia.
Mental HealthPremature Ejaculation Diagnostic Tool (PEDT)
A 5-question tool to help identify men who may have a problem with premature ejaculation (PE) during sexual activity.
Mental HealthPremature Ejaculation Profile (PEP)
A 4-item patient self-reported questionnaire to assess the impact and severity of premature ejaculation (PE).
Mental HealthProfessional Quality of Life Scale (ProQOL 5)
A 30-item self-report measure of compassion satisfaction, burnout, and secondary traumatic stress for helping profession
Mental HealthProfessional Quality of Life Scale for Health Workers (ProQOL Health)
Measures compassion satisfaction, burnout, and secondary traumatic stress for healthcare professionals based on the ProQ
CardiologyQuality of Life Survey (VASCUQOL-6)
Validated instrument for the assessment of health-related quality of life in peripheral arterial disease (PAD).
UrologyQuantitative Androgen Deficiency in the Aging Male (qADAM)
10-item symptom survey to facilitate the detection of men at risk for androgen (or testosterone) deficiency.
Family PracticeQuestionnaire For Genito-Pelvic Dysethesia (GPD)
Captures the physical quality and the psychological distress of sensations of arousal that occur without sexual desire.
AnesthesiologyRevised Cardiac Risk Index for Pre-operative Risk
Estimates risk of cardiac complications after noncardiac surgery
AnesthesiologyRevised Opioid Risk Tool (ORT-OUD)
Measures risk of aberrant drug-related behaviors in patients with chronic pain prescribed opioid therapy.
Family PracticeRoland-Morris Disability Questionnaire
Measures functional disability and activity limitations in patients with low back pain.
SurgerySatisfaction Survey for Inflatable Penile Implant (SSIPI)
A 16-question survey for patients to report their satisfaction and experience with their inflatable penile implant.
Family PracticeScoliosis Research Society QoL - Revised (SRS-22r)
22-item quality of life survey across function, pain, self-image, mental health, & treatment satisfaction for scoliosis
Mental HealthSeverity Measure for Panic Disorder - Adult
Assesses the severity of panic disorder symptoms
Mental HealthSexual Desire Inventory-2 (SDI-2)
Self-report questionnaire designed to measure various facets of sexual desire.
Family PracticeSexual Health Inventory For Men (SHIM) or IIEF-5
5-item quiz to identify erectile dysfunction and severity. AKA the International Index of Erectile Function-5 (IIEF-5)
Family PracticeSimple Shoulder Test
12-item assessment of shoulder pain, function, and disability across comfort, mobility, strength, and work capacity.
AnesthesiologySTOP-BANG Score for Obstructive Sleep Apnea
Screens for obstructive sleep apnea
Family PracticeTegner Lysholm Knee Score
Assessment of knee function and symptoms affecting daily activities and sports participation.
Mental HealthThe Greene Climacteric Scale (GCS)
A 21-item questionnaire that captures the symptoms that occur in perimenopause.
Family PracticeThe Pelvic Pain Impact Questionnaire (PPIQ)
A 10-item tool for women to assess the impact of their pelvic pain on daily life and function.
Mental HealthThe RAND (v.1) 36-Item Short Form Survey Instrument (SF-36)
A 36-item, patient-reported survey (RAND v.1) measuring health status and quality of life across eight health domains.
Clinical Outcomes Assessment (COA)The RAND 20-Item Short Form Health Survey (SF-20)
A 20-item, patient-reported survey (RAND v.1) measuring health status and quality of life across six health domains.
Clinical Outcomes Assessment (COA)Vulvar Pain Functional Questionnaire (V-Q)
11-item survey assessing how pelvic pain affects everyday life.
Family PracticeWestern Ontario Shoulder Instability Index (WOSI)
Measures functional disability/symptoms related to shoulder instability across physical, activity, lifestyle, & emotion.
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