Use our readymade template to create your Perceived Stress Scale (PSS) screening tool for stress
Create your care assessments
| PSS score | Stress Level | Proposed treatment |
|---|---|---|
| 0-13 | Low stress | May not need treatment |
| 14-26 | Moderate stress | Consider counseling |
| 27-40 | High perceived stress | Active treatment |
- Prebuilt template with PSS scoring to assess the perception of stress
- 10-item questionnaire that scores each item from “0” (never) to “4” (very often)
- Real-time calculation of PSS Score and stress level based on the form responses
- Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
- Compare the scores from the initial screening with that of the followup to track the progression of stress
- Easily create responsive forms that allow patients to complete their assessments on any device at any time
Collect responses from your patients
| Patient ID | 1004 |
| Patient Name | John W |
| Patient Email | johnw@ymail.com |
| Patient Phone Number | 0987654321 |
| 1. In the last month, how often have you been upset because of something that happened unexpectedly? | Sometimes |
| 2. In the last month, how often have you felt that you were unable to control the important things in your life? | Fairly often |
| 3. In the last month, how often have you felt nervous and stressed? | Very often |
| 4. In the last month, how often have you felt confident about your ability to handle your personal problems? | Sometimes |
| 5. In the last month, how often have you felt that things were going your way? | Almost never |
| 6. In the last month, how often have you found that you could not cope with all the things that you had to do? | Very often |
| 7. In the last month, how often have you been able to control irritations in your life? | Sometimes |
| 8. In the last month, how often have you felt that you were on top of things? | Almost never |
| 9. In the last month, how often have you been angered because of things that happened that were outside of your control? | Fairly often |
| 10. In the last month, how often have you felt difficulties were piling up so high that you could not overcome them? | Very often |
| PSS Score | 30 |
| Stress Level | High perceived stress |
- Pre-populate patient details such as patient id, name, email etc in the PSS assessment form before sharing it with the patients
- Send an email invitation with a secure link for patients to complete their PSS assessment form prior to their visit
- Allow patients to save their progress and complete their PSS assessment form at a later time without losing any responses
- Set up an email template for your PSS assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their PSS score, diagnosis, next steps when they submit their PSS assessment
Track patient responses in Google Sheets
| A | B | C | D | E | |
|---|---|---|---|---|---|
| 1 | Name | Question | Answer | Score | Total Score |
| 2 | John W | 1. In the last month, how often have you been upset because of something that happened unexpectedly? | Sometimes | 2 | 30 |
| 3 | John W | 2. In the last month, how often have you felt that you were unable to control the important things in your life? | Fairly often | 3 | 30 |
| 4 | John W | 3. In the last month, how often have you felt nervous and stressed? | Very often | 4 | 30 |
| 5 | John W | 4. In the last month, how often have you felt confident about your ability to handle your personal problems? | Sometimes | 2 | 30 |
| 6 | John W | 5. In the last month, how often have you felt that things were going your way? | Almost never | 3 | 30 |
| 7 | John W | 6. In the last month, how often have you found that you could not cope with all the things that you had to do? | Very often | 4 | 30 |
| 8 | John W | 7. In the last month, how often have you been able to control irritations in your life? | Sometimes | 2 | 30 |
| 9 | John W | 8. In the last month, how often have you felt that you were on top of things? | Almost never | 3 | 30 |
| 10 | John W | 9. In the last month, how often have you been angered because of things that happened that were outside of your control? | Fairly often | 3 | 30 |
| 11 | John W | 10. In the last month, how often have you felt difficulties were piling up so high that you could not overcome them? | Very often | 4 | 30 |
- Export patient responses including the calculated PSS score and stress level to Google Sheets for easy record-keeping
- Export individual points for 10 items to Google Sheets for data manipulation and analysis for comprehensive insights
- Use pre-built reports to easily keep track of patient progress over time and monitor changes in their stress levels
- Receive a copy of the response and the calculated PSS score by email whenever a patient submits their PSS assessment
- Use data in Google Sheets to integrate with external EHR systems for seamless data transfer
HIPAA compliance
| Patient ID: | 1004 |
| Patient Name: | ****** |
| Patient Email: | ****** |
| Patient Phone Number: | ****** |
| 1. In the last month, how often have you been upset because of something that happened unexpectedly?: | Sometimes |
| 2. In the last month, how often have you felt that you were unable to control the important things in your life?: | Fairly often |
| 3. In the last month, how often have you felt nervous and stressed?: | Very often |
| 4. In the last month, how often have you felt confident about your ability to handle your personal problems?: | Sometimes |
| 5. In the last month, how often have you felt that things were going your way?: | Almost never |
| 6. In the last month, how often have you found that you could not cope with all the things that you had to do?: | Very often |
| 7. In the last month, how often have you been able to control irritations in your life?: | Sometimes |
| 8. In the last month, how often have you felt that you were on top of things?: | Almost never |
| 9. In the last month, how often have you been angered because of things that happened that were outside of your control?: | Fairly often |
| 10. In the last month, how often have you felt difficulties were piling up so high that you could not overcome them?: | Very often |
| PSS Score: | 30 |
| Stress Level: | High perceived stress |
| PSS Score: | 30 |
| Stress Level: | High perceived stress |
- Create a HIPAA compliant PSS assessment form to safely collect, store and access patient responses
- Mark fields as Protected Health Information (PHI) to secure sensitive patient data and limit access to PHI
- Automatically mask PHI fields when exporting PSS form responses to Google Sheets and sending them on email
- Prepopulate patient details in PSS assessments by creating secure prefill links without exposing PHI
- Limit access to patient data only for authorized personnel and minimize the risk of data breaches
These reviews are reproduced without modification from Google Workspace Marketplace.
July 23, 2023
I am not tech savvy. I chose formesign to help create registration links for clients. Vipid has been great in assisting me. He goes above and beyond. My company now has moved from the stone age to modern age through the ability to use this feature. Of the many features I am impressed with, the ability to update a form without needing to regenerate a link is amazing. I often make mistakes and that ability allows me to fix mistakes without needing to change everything. Thank you!!!
— Sol Evans
October 31, 2023
We needed a way to create forms with e-signatures and this app made it very easy. Support is also very quick and always helpful. Cannot recommend enough!
— Chris Henesy
February 16, 2024
Does not work
— Myles Sicuro
July 12, 2023
It very friendly to used. I love it. For my case multiple signature needed. it's supporting
— Senthil Kumar
November 27, 2023
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July 10, 2023
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— Joan S