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Toolbox of Forms

A. Medical History and Record Requests
Forms to be prepared by parents and other physicians

  • Child and Adolescent Intake Questionnaire - Parent form-1 (2 pages)
  • Child and Adolescent Intake Questionnaire - Parent form-2 (17 pages)
  • Child and Adolescent Intake Questionnaire - Parent form-3 (7 pages)
  • Child and Adolescent Psychiatrist Practice Telephone Intake Request for Medical Records
  • Practice Forms/HIPAA Disclosures

B. (and D). Baseline (and Repeat Monitoring) of Clinical Symptoms
Scales for Baseline and Repeat Clinical Monitoring

  • Center for Epidemiological Studies Depression Scale for Children (CES-DC) 
  • Columbia Impairment Scale (CIS)
  • Child Mania Rating Scale- Parent Version (PBD Screener) (CMRS-P)
  • Johns Hopkins Depression Checklist for Children
  • Kutcher Generalized Social Anxiety Disorder Scale for Adolescents(K-GSADS-A)
  • Mood and Feelings Questionnaire (MFQ)
  • Patient Health Questionnaire: Modified for Teens
  • Services Assessment for Children and Adolescents Brieftest (SACA)
  • Screen for Child Anxiety Related Disorders - Child Version (SCARED-Child)
  • Screen for Child Anxiety Related Disorders - Parent Version (SCARED-Parent)
  • SNAP IV -18 Item
  • Vanderbilt ADHD Assessment Scale - Parent Informant
    • Vanderbilt ADHD Assessment Follow Up - Parent Informant
  • Vanderbilt ADHD Assessment Scale - Teacher Informant
    • Vanderbilt ADHD Assessment Follow Up - Teacher Informant

C. Baseline Medication

  • Massachusetts General Hospital CV Screen
  • Medication Consent - Alpha Agonists
  • Medication Consent - Antipsychotics
  • Medication Consent - Antidepressants/Antianxiety
  • Medication Consent - Atomoxetine (Strattera)
  • Medication Consent - Other
  • Medication Consent - Stimulants for ADHD

D. Medication Monitoring
Medication response and side effect ratings by parents.

  • Abnormal Involuntary Movement Scale (AIMS)
  • Medication Side Effect Monitoring
  • Stimulant Monitoring Form

E. Outcome Scales
Use of health services.

  • Health of the Nations Outcome for Children and Adolescents (HoNOSCA)

F. Psychopharmacological Information Sources (Professionals and Families)
Information and reporting for professionals and families.

  • Medication Guide for Parents
  • Medline Plus
  • MedWatch Report
  • National Alliance on Mental Illness (NAMI) Handbook for Parents

G. Clinical Care and Quality Improvement - Rating Scales

The AACAP Toolbox for Clinical Practice and Outcomes Research Resource Center was developed in collaboration with the Pediatric Psychopharmacology Initiative (PPI) under the AACAP Research Committee and the AACAP Consumer Issues Committee. For questions, please contact the AACAP Research, Training and Education Department at research@aacap.org.

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©2023 The American Academy of Child and Adolescent Psychiatry Contact

3615 Wisconsin Avenue, N.W.
Washington, D.C. 20016-3007

Phone: 202.966.7300
Fax: 202.464.0131
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