Use our readymade template to create your Social Phobia Inventory (SPIN) screening tool for social anxiety disorder
Create your care assessments
| SPIN score | Symptom Severity | Proposed treatment |
|---|---|---|
| 0-20 | None | May not need treatment |
| 21-30 | Mild | Consider counseling |
| 31-40 | Moderate | Consider medication and therapy |
| 41-50 | Severe | Active treatment |
| 51-68 | Very Severe | Immediate initiation |
- Prebuilt template with SPIN scoring to assess the presence of social anxiety disorder and measure its severity
- 17-item questionnaire that scores each item from “0” (not at all) to “4” (extremely)
- Real-time calculation of SPIN Score and symptom severity 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 social anxiety disorder
- Easily create responsive forms that allow patients to complete their assessments on any device at any time
Collect responses from your patients
| Patient ID | 1005 |
| Patient Name | Jane D |
| Patient Email | janed@ymail.com |
| Patient Phone Number | 1234567890 |
| Doctor's Name | Dr. Smith |
| Location | New York |
| For each statement below, please select the answer that best describes how you have been feeling during the last week | |
| I am afraid of people in authority. | Very Much |
| I am bothered by blushing in front of people. | Somewhat |
| Parties and social events scare me. | A Little Bit |
| I avoid talking to people I don’t know. | Not At All |
| Being criticized scares me a lot. | Very Much |
| I avoid doing things or speaking to people for fear of embarrassment. | Extremely |
| Sweating in front of people causes me distress. | Somewhat |
| I avoid going to parties. | A Little Bit |
| I avoid activities in which I am the center of attention. | Very Much |
| Talking to strangers scares me. | Somewhat |
| I avoid having to give speeches. | Not At All |
| I would do anything to avoid being criticized. | Very Much |
| Heart palpitations bother me when I am around people. | Somewhat |
| I am afraid of doing things when people might be watching. | A Little Bit |
| Being embarrassed or looking stupid are among my worst fears. | Very Much |
| I avoid speaking to anyone in authority. | Somewhat |
| Trembling or shaking in front of others is distressing to me. | A Little Bit |
| SPIN Score | 38 |
| Symptom Severity | Moderate |
- Pre-populate patient details such as patient id, name, email etc in the SPIN assessment form before sharing it with the patients
- Send an email invitation with a secure link for patients to complete their SPIN assessment form prior to their visit
- Allow patients to save their progress and complete their SPIN assessment form at a later time without losing any responses
- Set up an email template for your SPIN assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their SPIN score, diagnosis, next steps when they submit their SPIN assessment
Track patient responses in Google Sheets
| A | B | C | D | E | |
|---|---|---|---|---|---|
| 1 | Name | Question | Answer | Score | Total Score |
| 2 | Jane D | I am afraid of people in authority. | Very Much | 3 | 38 |
| 3 | Jane D | I am bothered by blushing in front of people. | Somewhat | 2 | 38 |
| 4 | Jane D | Parties and social events scare me. | A Little Bit | 1 | 38 |
| 5 | Jane D | I avoid talking to people I don’t know. | Not At All | 0 | 38 |
| 6 | Jane D | Being criticized scares me a lot. | Very Much | 3 | 38 |
| 7 | Jane D | I avoid doing things or speaking to people for fear of embarrassment. | Extremely | 4 | 38 |
| 8 | Jane D | Sweating in front of people causes me distress. | Somewhat | 2 | 38 |
| 9 | Jane D | I avoid going to parties. | A Little Bit | 1 | 38 |
| 10 | Jane D | I avoid activities in which I am the center of attention. | Very Much | 3 | 38 |
| 11 | Jane D | Talking to strangers scares me. | Somewhat | 2 | 38 |
| 12 | Jane D | I avoid having to give speeches. | Not At All | 0 | 38 |
| 13 | Jane D | I would do anything to avoid being criticized. | Very Much | 3 | 38 |
| 14 | Jane D | Heart palpitations bother me when I am around people. | Somewhat | 2 | 38 |
| 15 | Jane D | I am afraid of doing things when people might be watching. | A Little Bit | 1 | 38 |
| 16 | Jane D | Being embarrassed or looking stupid are among my worst fears. | Very Much | 3 | 38 |
| 17 | Jane D | I avoid speaking to anyone in authority. | Somewhat | 2 | 38 |
| 18 | Jane D | Trembling or shaking in front of others is distressing to me. | A Little Bit | 1 | 38 |
- Export patient responses including the calculated SPIN score and symptom severity to Google Sheets for easy record-keeping
- Export individual points for 17 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 social anxiety symptoms
- Receive a copy of the response and the calculated SPIN score by email whenever a patient submits their SPIN assessment
- Use data in Google Sheets to integrate with external EHR systems for seamless data transfer
HIPAA compliance
| Patient ID: | 1005 |
| Patient Name: | ****** |
| Patient Email: | ****** |
| Patient Phone Number: | ****** |
| Doctor's Name: | Dr. Smith |
| Location: | New York |
| For each statement below, please select the answer that best describes how you have been feeling during the last week | |
| I am afraid of people in authority.: | Very Much |
| I am bothered by blushing in front of people.: | Somewhat |
| Parties and social events scare me.: | A Little Bit |
| I avoid talking to people I don’t know.: | Not At All |
| Being criticized scares me a lot.: | Very Much |
| I avoid doing things or speaking to people for fear of embarrassment.: | Extremely |
| Sweating in front of people causes me distress.: | Somewhat |
| I avoid going to parties.: | A Little Bit |
| I avoid activities in which I am the center of attention.: | Very Much |
| Talking to strangers scares me.: | Somewhat |
| I avoid having to give speeches.: | Not At All |
| I would do anything to avoid being criticized.: | Very Much |
| Heart palpitations bother me when I am around people.: | Somewhat |
| I am afraid of doing things when people might be watching.: | A Little Bit |
| Being embarrassed or looking stupid are among my worst fears.: | Very Much |
| I avoid speaking to anyone in authority.: | Somewhat |
| Trembling or shaking in front of others is distressing to me.: | A Little Bit |
| SPIN Score: | 38 |
| Symptom Severity: | Moderate |
| SPIN Score: | 38 |
| Symptom Severity: | Moderate |
- Create a HIPAA compliant SPIN 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 SPIN form responses to Google Sheets and sending them on email
- Prepopulate patient details in SPIN 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
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