Use our readymade template to create your Positive and Negative Affect Schedule (PANAS) for assessing mood
Create your care assessments
| Positive Affect Score | Negative Affect Score | Proposed treatment |
|---|---|---|
| 10-50 | 10-50 | May need treatment |
- 20-item questionnaire that scores each item as “1” (Very Slightly or Not at All) to “5” (Extremely)
- Real-time calculation of Positive Affect Score and Negative Affect Score based on the form responses
- Collect patient data and other sensitive healthcare data using our HIPAA compliant online assessment forms
- 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 |
| Doctor's Name | Dr. Smith |
| Location | New York |
| Indicate to what extent you have felt this way during the past week. | |
| Interested | Quite a Bit |
| Distressed | A Little |
| Excited | Moderately |
| Upset | Quite a Bit |
| Strong | Extremely |
| Guilty | A Little |
| Scared | Moderately |
| Hostile | Quite a Bit |
| Enthusiastic | Extremely |
| Proud | A Little |
| Irritable | Moderately |
| Alert | Quite a Bit |
| Ashamed | Extremely |
| Inspired | A Little |
| Nervous | Moderately |
| Determined | Quite a Bit |
| Attentive | Extremely |
| Jittery | A Little |
| Active | Moderately |
| Afraid | Quite a Bit |
| Positive Affect Score | 40 |
| Negative Affect Score | 35 |
- Pre-populate patient details such as patient id, name, email etc in the PANAS assessment form before sharing it with the patients
- Send an email invitation with a secure link for patients to complete their PANAS assessment form prior to their visit
- Allow patients to save their progress and complete their PANAS assessment form at a later time without losing any responses
- Set up an email template for your PANAS assessment and automatically send invitation emails to multiple patients with ease
- Send a confirmation email to the patients with their Positive Affect Score, Negative Affect Score, diagnosis, next steps when they submit their PANAS assessment
Track patient responses in Google Sheets
| A | B | C | D | E | |
|---|---|---|---|---|---|
| 1 | Name | Question | Answer | Score | Total Score |
| 2 | John W | Interested | Quite a Bit | 4 | 40 |
| 3 | John W | Distressed | A Little | 2 | 40 |
| 4 | John W | Excited | Moderately | 3 | 40 |
| 5 | John W | Upset | Quite a Bit | 4 | 40 |
| 6 | John W | Strong | Extremely | 5 | 40 |
| 7 | John W | Guilty | A Little | 2 | 40 |
| 8 | John W | Scared | Moderately | 3 | 40 |
| 9 | John W | Hostile | Quite a Bit | 4 | 40 |
| 10 | John W | Enthusiastic | Extremely | 5 | 40 |
| 11 | John W | Proud | A Little | 2 | 40 |
| 12 | John W | Irritable | Moderately | 3 | 40 |
| 13 | John W | Alert | Quite a Bit | 4 | 40 |
| 14 | John W | Ashamed | Extremely | 5 | 40 |
| 15 | John W | Inspired | A Little | 2 | 40 |
| 16 | John W | Nervous | Moderately | 3 | 40 |
| 17 | John W | Determined | Quite a Bit | 4 | 40 |
| 18 | John W | Attentive | Extremely | 5 | 40 |
| 19 | John W | Jittery | A Little | 2 | 40 |
| 20 | John W | Active | Moderately | 3 | 40 |
| 21 | John W | Afraid | Quite a Bit | 4 | 40 |
- Export patient responses including the calculated Positive Affect Score and Negative Affect Score to Google Sheets for easy record-keeping
- Export individual points for 20 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 mood
- Receive a copy of the response and the calculated Positive Affect Score and Negative Affect Score by email whenever a patient submits their PANAS 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: | ****** |
| Doctor's Name: | Dr. Smith |
| Location: | New York |
| Indicate to what extent you have felt this way during the past week. | |
| Interested: | Quite a Bit |
| Distressed: | A Little |
| Excited: | Moderately |
| Upset: | Quite a Bit |
| Strong: | Extremely |
| Guilty: | A Little |
| Scared: | Moderately |
| Hostile: | Quite a Bit |
| Enthusiastic: | Extremely |
| Proud: | A Little |
| Irritable: | Moderately |
| Alert: | Quite a Bit |
| Ashamed: | Extremely |
| Inspired: | A Little |
| Nervous: | Moderately |
| Determined: | Quite a Bit |
| Attentive: | Extremely |
| Jittery: | A Little |
| Active: | Moderately |
| Afraid: | Quite a Bit |
| Positive Affect Score: | 40 |
| Negative Affect Score: | 35 |
| Positive Affect Score: | 40 |
- Create a HIPAA compliant PANAS 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 PANAS form responses to Google Sheets and sending them on email
- Prepopulate patient details in PANAS 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.
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