Template library · Assessments & screeners
Brief Suicide Risk Screen template
Quick screen to identify clients who need a full risk assessment.
Rapid screen for use in general clinical settings
- 14 fields across 4 sections
- Included with MyWellOps
- Edit it, or save your own version
What’s in it
Assessment Details
- Client NameText
- Date of BirthDate
- Client ID / MRNText
- Date of AssessmentDate
- Clinician / CoachText
- Location / ModalityText
Screening Items
- In the past month, wished to be deadTick box
- In the past month, had thoughts of killing selfTick box
- Currently has a plan to kill selfTick box
- Has made a suicide attempt in their lifetimeTick box
Disposition
- Level of risk determinedText
- Actions taken (referral, hospitalization, safety plan)Text
Signatures
- Clinician SignatureSignature
- Date signed (clinician)Date
When to use it
Use an assessment at the start of work to set a baseline, then repeat it at review points so you and the client can see what has changed.
How it works in MyWellOps
- Pick it from Documents.
- Send it to the client to complete, or fill it in together during a session.
- Each completed copy is kept on the client’s record, so earlier results are there to compare.
Spend less time on admin, more time with clients
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